Individual
BETHANY ANN GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 PAR LN, MAIDSVILLE, WV 26541-8186
(304) 703-0498
Mailing address
34 PAR LN, MAIDSVILLE, WV 26541-8186
(304) 703-0498
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
109769
WV
Other
Enumeration date
10/22/2024
Last updated
01/24/2025
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