Provider Demographics
NPI:1043210602
Name:CHADWICK, BETHANN M (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANN
Middle Name:M
Last Name:CHADWICK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5160
Mailing Address - Country:US
Mailing Address - Phone:717-741-9063
Mailing Address - Fax:717-741-3643
Practice Address - Street 1:2675 JOPPA RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5160
Practice Address - Country:US
Practice Address - Phone:717-741-9063
Practice Address - Fax:717-741-3643
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics