Individual
BETHANY C PAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1319 LEAVENWORTH ST, OMAHA, NE 68102-3215
(402) 552-3222
(402) 552-2172
Mailing address
PO BOX 307, ADVANCE, NC 27006-0307
(336) 745-8395
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NE
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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