Individual
BETHANY E HUELSKOETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
6702 GODFREY ROAD, GODFREY, IL 62035
(618) 467-1520
(618) 467-1521
Mailing address
6702 GODFREY ROAD, GODFREY, IL 62035
(618) 467-1520
(618) 467-1521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016870
IL
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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