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Individual
BETHANY JEAN LUPA
Active
Individual
BETHANY JEAN LUPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., C.N.M.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704244262
MI
176B00000X
Midwife
4704244262
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704244262
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704244262
STATE LICENSE
MI
Enumeration date
06/22/2007
Last updated
09/30/2026
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