Individual
MS. BETHANY L. JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
248 STATE ST, SUITE 3A, ELLSWORTH, ME 04605-1850
(207) 812-7031
(207) 660-4203
Mailing address
PO BOX 587, AUGUSTA, ME 04332-0587
(207) 509-3271
(207) 509-3271
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN28734
ME
363LF0000X
Family Nurse Practitioner
Primary
CNP81355
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248660099
MEDICAID - PERS
ME
Enumeration date
06/11/2006
Last updated
09/28/2015
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