Individual
BETHANY GRACE TITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.020011
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0193082
—
OH
Enumeration date
10/10/2016
Last updated
10/11/2024
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