Provider Demographics
NPI:1538926092
Name:WITTMER, BETH ANN (BSN RN)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:WITTMER
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1963 RACIMO DR
Mailing Address - Street 2:RACIMO DR.
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9426
Mailing Address - Country:US
Mailing Address - Phone:941-928-8372
Mailing Address - Fax:
Practice Address - Street 1:1963 RACIMO DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9426
Practice Address - Country:US
Practice Address - Phone:941-928-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2553442163WG0000X, 163WN1003X, 163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WX0200XNursing Service ProvidersRegistered NurseOncologyGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support