Bourquin, Beth Alyson

Bourquin, Beth Alyson is an sole proprietor health care provider with primary practice located at 1 Childrens Plz , Dayton OH 45404-1873. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Bourquin, Beth Alyson can be contacted via phone (937) 641-5444.

Contact Information

Primary practice address
1 Childrens Plz Dayton OH 45404-1873
Phone: (937) 641-5444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X 021714 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X APRN.CNP.021714 Ohio

Profile Details

NPI number 1144732579
LBN Legal business name Bourquin, Beth Alyson
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2017
Last updated May 28th, 2026 - about 5 months 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 1144732579 NPPES
Ohio MEDICAID 0250859

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