Dekoninck, Beth Ann

Dekoninck, Beth Ann is an individual health care provider with primary practice located at 207 E Meadow Rd Ste 6 , Eden NC 27288-3469. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Dekoninck, Beth Ann can be contacted via phone (219) 204-1854.

Contact Information

Primary practice address
207 E Meadow Rd Ste 6 Eden NC 27288-3469
Phone: (219) 204-1854
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 71000315A Indiana

Profile Details

NPI number 1285693960
LBN Legal business name Dekoninck, Beth Ann
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Nov 26th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285693960 NPPES
Indiana MEDICAID 200169950
Indiana Other 000000372024
Indiana Other 9397614

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