Individual
BETHANY ANNA FREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP- BC
Contact information
Practice address
1002 E MADISON ST, HOUSTON, MS 38851-2428
(662) 567-2865
Mailing address
129 NEW WINE DR, HOUSTON, MS 38851-2511
(662) 567-2865
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904095
MS
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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