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Individual
BETHANY EIDE
Active
Individual
BETHANY EIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
37971
MT
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
37971
MT
163WW0000X
Wound Care Registered Nurse
37971
MT
Other
Enumeration date
12/26/2023
Last updated
12/26/2023
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