Provider Demographics
NPI:1164047395
Name:BUCHANAN, BETHANY MARIE (APRN-CNP)
Entity Type:Individual
Prefix:MISS
First Name:BETHANY
Middle Name:MARIE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:MARIE
Other - Last Name:BOGANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-5123
Mailing Address - Fax:614-293-4980
Practice Address - Street 1:2231 N HIGH ST FL 1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-1101
Practice Address - Country:US
Practice Address - Phone:614-293-5123
Practice Address - Fax:614-293-4980
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily