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Individual

MS. BETH CLAY HEROLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP, DNP

Contact information

Practice address
4020 N ROXBORO ST, DURHAM, NC 27704-2120
(919) 479-2690
Mailing address
5213 S ALSTON AVE, DURHAM, NC 27713-4430
(919) 684-8111

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5005669
NC
363LP0200X
Pediatric Nurse Practitioner
252884
NC
363LP0200X
Pediatric Nurse Practitioner
RN3246712
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
252884
NORTH CAROLINA NURSING LICENSE
NC
05
303217500
FL
01
5005669
NORTH CAROLINA BOARD OF NURSING, NP CERTIFICATE
NC
01
RN3246712
NURSING LICENSE NUMBER
FL
Enumeration date
06/25/2006
Last updated
07/30/2012
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