Individual
BETHANY GRACE AVILA OTTE
Active
Individual
BETHANY GRACE AVILA OTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95104464
CA
363LP2300X
Primary Care Nurse Practitioner
95006063
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN2367980
MA
Other
Enumeration date
03/01/2017
Last updated
06/30/2025
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