Individual
DIANNA BETHANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 GOLF COURSE RD SE STE 106, RIO RANCHO, NM 87124-2575
(505) 892-4861
(855) 387-0467
Mailing address
1001 GOLF COURSE RD SE STE 106, RIO RANCHO, NM 87124-2575
(505) 892-4861
(855) 387-0467
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88201899
—
NM
Enumeration date
01/18/2023
Last updated
01/18/2023
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