Individual
MRS. BETHANY LAURIAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP-C
Contact information
Practice address
320 W MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-1940
(417) 461-0056
(833) 707-1944
Mailing address
320 W MOUNT VERNON BLVD, MOUNT VERNON, MO 65712-1940
(417) 461-0056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2025001784
MO
Other
Enumeration date
01/24/2025
Last updated
03/04/2025
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