Individual provider Active NPI

Beth D McNett-Fettinger, CPNP

  • Pediatric Nurse Practitioner
  • Saginaw, MI
National Provider Identifier
1073611851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704126800 Issued in MI
Practice address
5821 Colony Dr N
Saginaw, MI 48638-5716
Phone
(989) 797-1051
Fax
(989) 799-0256
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704126800 MI Primary

Addresses

Primary practice location

5821 Colony Dr N
Saginaw, MI 48638-5716

Mailing address

4242 N Hemlock Rd
Hemlock, MI 48626-9685
Phone (989) 642-4242

Other identifiers 1

IdentifierTypeStateIssuer
4704126800OtherMIREGISTERED NURSE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704126800MIMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073611851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 N HEMLOCK RD",
            "city": "HEMLOCK",
            "state": "MI",
            "postal_code": "486269685",
            "telephone_number": "989-642-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 COLONY DR N",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486385716",
            "telephone_number": "989-797-1051",
            "fax_number": "989-799-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNETT-FETTINGER",
        "first_name": "BETH",
        "middle_name": "D",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704126800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "4704126800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.