Individual
BETHANY WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3917 WEST RD, LOS ALAMOS, NM 87544-2275
(573) 686-5550
Mailing address
860 ASTER ST, LOS ALAMOS, NM 87547-3869
(573) 686-5550
(573) 686-2139
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2015013955
MO
Other
Enumeration date
03/30/2015
Last updated
01/14/2021
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