Provider Demographics
NPI:1467030742
Name:MCMINN, BETHANY DIANNA (NP)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:DIANNA
Last Name:MCMINN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6741 COUNTY ROAD 202
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7337
Mailing Address - Country:US
Mailing Address - Phone:214-551-3567
Mailing Address - Fax:
Practice Address - Street 1:920 W VAN ALSTYNE PKWY
Practice Address - Street 2:
Practice Address - City:VAN ALSTYNE
Practice Address - State:TX
Practice Address - Zip Code:75495-3531
Practice Address - Country:US
Practice Address - Phone:032-180-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily