Individual
ELENA EVGENIEVNA BETHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-010821
IL
363L00000X
Nurse Practitioner
H114268
IA
Other
Enumeration date
10/17/2013
Last updated
08/11/2023
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