Provider Demographics
NPI:1053500330
Name:MILLER, BETHANY LYNN (NP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:BETHANY
Other - Middle Name:LYNN
Other - Last Name:MERKLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:777 SOUTH CLINTON AVENUE
Mailing Address - Street 2:HIGHLAND FAMILY PLANNING
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620
Mailing Address - Country:US
Mailing Address - Phone:585-279-4733
Mailing Address - Fax:585-442-8319
Practice Address - Street 1:777 SOUTH CLINTON AVENUE
Practice Address - Street 2:HIGHLAND FAMILY PLANNING
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-279-4733
Practice Address - Fax:585-442-8319
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335245363LF0000X
NYF335245363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400008414Medicare PIN