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Individual

MRS. BETHANY LEIGH WAYT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RNC, CNM

Contact information

Practice address
1108 VESTER AVE, SPRINGFIELD, OH 45503-1302
(937) 399-7100
Mailing address
1108 VESTER AVE, SPRINGFIELD, OH 45503-1302
(937) 399-7100

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
COA 11370-NM
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3088251
OH
01
NM041111
MEDICARE PTAN
OH
Enumeration date
07/30/2010
Last updated
08/12/2024
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