Individual
BETHANY LEANN BEACHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9003 N GARNETT RD, OWASSO, OK 74055-4495
(918) 272-2882
Mailing address
1722 N 4TH ST STE F, PONCA CITY, OK 74601-2745
(580) 762-2366
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2953
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2953
PA LICENSE
OK
Enumeration date
02/14/2020
Last updated
02/14/2020
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