Individual
BETHANY O'DEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(719) 234-7826
Mailing address
55 FRUIT STREET, WACC 460, BOSTON, MA 02114
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2348098
MA
Other
Enumeration date
08/25/2022
Last updated
09/06/2023
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