Provider Demographics
NPI:1164118659
Name:GESKE, BETHANY (PMHNP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:GESKE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1876
Mailing Address - Country:US
Mailing Address - Phone:715-232-1314
Mailing Address - Fax:
Practice Address - Street 1:2772 EDDY LANE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703
Practice Address - Country:US
Practice Address - Phone:715-770-9180
Practice Address - Fax:877-341-6743
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13199-33363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health