Individual
BETHANY MICHIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3325 WILLOWCREEK RD, PORTAGE, IN 46368-5015
(219) 850-4490
Mailing address
8334 BEECH AVE, MUNSTER, IN 46321-1440
(312) 933-0661
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
71009873A
IN
Other
Enumeration date
03/10/2020
Last updated
07/06/2026
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