Individual
BETHANY R FISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 520-9075
Mailing address
15146 16TH AVE, MARNE, MI 49435-9605
(616) 520-9075
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704278617
MI
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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