Individual
MRS. BETH A DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
215 EAST MAIN STREET, PROVIDENCE, KY 42450-1261
(270) 667-7017
Mailing address
PO BOX 9150, REGIONAL HEALTH CARE AFFILIATES, PADUCAH, KY 42002-9150
(270) 667-7017
(270) 667-9065
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004408
KY
363LF0000X
Family Nurse Practitioner
4408P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000351079
BCBS PROVIDER NUMBER
—
01
—
4408P
LICENSE
KY
05
—
78013083
—
KY
Enumeration date
09/17/2006
Last updated
07/14/2015
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