Individual
BETHANY D YAGER HOUZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 629-5991
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-0982
(502) 588-0987
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3010598
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201406570
—
IN
05
—
7100434550
—
KY
Enumeration date
10/26/2016
Last updated
10/11/2020
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