Individual
BETHANY MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
Mailing address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
363LF0000X
Family Nurse Practitioner
9321760
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9321760
FL
Other
Enumeration date
07/26/2017
Last updated
11/11/2024
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