Individual
BETH AIMEE BAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 MARYS AVE, KINGSTON, NY 12401-5829
(845) 338-2500
Mailing address
105 MARYS AVE, KINGSTON, NY 12401-5829
(845) 338-2500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405520
NY
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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