Individual
BETHANN H DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
759 GRANITE ST, SOUTH SHORE HEALTH CENTER, BRAINTREE, MA 02184
(781) 848-1950
(781) 356-4887
Mailing address
759 GRANITE ST, SOUTH SHORE HEALTH CENTER, BRAINTREE, MA 02184
(781) 848-1950
(781) 356-4887
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
194673
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP9770
BCBSMA
MA
Enumeration date
01/25/2006
Last updated
10/29/2007
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