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Individual

BETHANY STUTZMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
150 N AZUSA AVE, AZUSA, CA 91702-3521
(626) 969-7885
Mailing address
150 N AZUSA AVE, AZUSA, CA 91702-3521

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95054538
CA
363LF0000X
Family Nurse Practitioner
Primary
95005607
CA

Other

Enumeration date
12/06/2016
Last updated
12/06/2016
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