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MICHAELEA PATRICE BETHGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
21 SUSQUEHANNA VALLEY MALL DR STE A, SELINSGROVE, PA 17870-9148
(570) 374-7852
(570) 374-7932
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN607371
PA
363L00000X
Nurse Practitioner
Primary
SP021790
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1037677010001
PA
01
1B7884
MEDICARE
PA
Enumeration date
11/26/2019
Last updated
04/13/2022
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