Provider Demographics
NPI:1902146590
Name:BROWN, BETHANY
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPERITY
Mailing Address - State:PA
Mailing Address - Zip Code:15329-1203
Mailing Address - Country:US
Mailing Address - Phone:978-500-5067
Mailing Address - Fax:
Practice Address - Street 1:3915 PARK AVE
Practice Address - Street 2:
Practice Address - City:PROSPERITY
Practice Address - State:PA
Practice Address - Zip Code:15329-1203
Practice Address - Country:US
Practice Address - Phone:978-500-5067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula