Individual
MS. BETHANY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
164 SUMMIT AVE, C70, PROVIDENCE, RI 02906-2853
(401) 793-4545
(401) 793-7866
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00560
RI
Other
Enumeration date
10/18/2010
Last updated
08/04/2025
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