Provider Demographics
NPI:1588176911
Name:STRICKER, BETHANY LYNN (LICENSED MIDWIFE)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:STRICKER
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-6231
Mailing Address - Country:US
Mailing Address - Phone:571-230-7866
Mailing Address - Fax:
Practice Address - Street 1:804 CENTRE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6231
Practice Address - Country:US
Practice Address - Phone:571-230-7866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99304176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife