# NP BETHANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205465770
- **Authorized official:** BETHANY FETZER DNP, FNP-C, PMHNP-BC (OWNER)
- **Authorized official phone:** (815) 608-9277

## Contact information

- **Practice address:** 1520 E PIMA ST, PHOENIX, AZ 85034-4639
- **Practice address phone:** (602) 407-6280
- **Mailing address:** 9745 E HAMPTON AVE UNIT 1102, MESA, AZ 85209-6301
- **Mailing address phone:** (815) 608-9277

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2020
- **Last updated:** 12/03/2024