Individual
MS. BETHANY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
14 FRANKLIN ST, WESTFIELD, NY 14787-1009
(716) 224-3521
Mailing address
14 FRANKLIN ST, WESTFIELD, NY 14787-1009
(716) 224-3521
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305866
NY
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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