Individual
BETHE VISCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2861 W 26TH ST, ERIE, PA 16506-3064
(814) 835-8903
Mailing address
2861 W 26TH ST STE 2, ERIE, PA 16506-3064
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP019305
PA
Other
Enumeration date
11/19/2012
Last updated
05/24/2021
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