Provider Demographics
NPI:1518626563
Name:CAMPBELL, BETHANY (RN)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683-2130
Mailing Address - Country:US
Mailing Address - Phone:724-757-1664
Mailing Address - Fax:
Practice Address - Street 1:120 COUNTRY SIDE PLZ
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:PA
Practice Address - Zip Code:15666-1816
Practice Address - Country:US
Practice Address - Phone:724-547-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN602442163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse