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Individual

BRIDGET DENISE BETHEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
2840 N DYSART RD, GOODYEAR, AZ 85395-2338
(623) 536-5310
(401) 652-9787
Mailing address
PO BOX 748860, ATLANTA, GA 30374
(623) 433-0106
(623) 535-0741

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024169131
VA
363LF0000X
Family Nurse Practitioner
335325-1
NY
363LF0000X
Family Nurse Practitioner
Primary
AP5151
AZ
363LP2300X
Primary Care Nurse Practitioner
RN221907
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
873862
AZ
Enumeration date
07/31/2007
Last updated
08/11/2023
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