Individual
BETHANY NOBES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1680 WALDEN AVE, CHEEKTOWAGA, NY 14225-4914
(716) 894-7777
(716) 894-0604
Mailing address
1458 FOOTE AVE. EXT., JAMESTOWN, NY 14701
(716) 664-0420
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
269035
NY
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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