Individual
DIEDRA BETHUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
219 EAST MAIN ST, MISSOULA, MT 59802
(406) 728-5490
(406) 728-5497
Mailing address
2525 4TH AVENUE NORTH, SUITE 201, BILLINGS, MT 59101
(406) 248-3637
(406) 254-9330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN11641
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37116
BCBS
—
05
—
433449
—
MT
Enumeration date
11/15/2006
Last updated
07/08/2007
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