Individual
JULIANNE BETHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5633
Mailing address
PO BOX 64264, BALTIMORE, MD 21264-4264
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R065248
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753800600
—
MD
Enumeration date
04/21/2006
Last updated
01/29/2014
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