Individual
BETHANY M DEFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MPH, BSN
Contact information
Practice address
4050 BRIDGE VIEW DR, NORTH CHARLESTON, SC 29405-7488
(908) 892-6189
Mailing address
192 PRESIDENT ST, CHARLESTON, SC 29403-5238
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
244731
SC
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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