Individual
DOMINIQUE K BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
771 OLD NORCROSS RD STE 200, LAWRENCEVILLE, GA 30046-4980
(770) 339-1387
(770) 962-7868
Mailing address
771 OLD NORCROSS RD STE 200, LAWRENCEVILLE, GA 30046-4980
(770) 339-1387
(770) 962-7868
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN281107
GA
Other
Enumeration date
02/20/2019
Last updated
04/13/2023
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