Provider Demographics
NPI:1053560888
Name:KLUMP, BETH
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:KLUMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3572 BRODHEAD RD.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3572 BRODHEAD RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3101
Practice Address - Country:US
Practice Address - Phone:724-775-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053556363AM0700X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
138843W95Medicare UPIN