Individual
MS. BETH EILEEN SHEPARD DUTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 293-8228
(937) 293-8229
Mailing address
PO BOX 932759, CLEVELAND, OH 44193-0015
(937) 293-8228
(937) 293-8229
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.02487
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0807032
—
OH
01
—
430039229
RAILROAD MEDICARE
OH
Enumeration date
07/13/2005
Last updated
09/03/2020
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