Individual
BETHANY ELLEN IRISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2420 LAKE AVE, ASHTABULA, OH 44004-4954
(440) 997-2262
Mailing address
PO BOX 74751, CLEVELAND, OH 44194-0834
(440) 997-2262
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.13358-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077424
—
OH
Enumeration date
10/15/2012
Last updated
12/13/2021
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