Individual
BETHANY JANE SKOLNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4986 N ADAMS RD STE D, ROCHESTER, MI 48306-5017
(248) 475-4701
Mailing address
4986 N ADAMS RD STE D, ROCHESTER, MI 48306-5017
(248) 475-4701
(248) 475-5777
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704270610
MI
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704270610
LICENSE
MI
Enumeration date
06/11/2019
Last updated
06/11/2019
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