Provider Demographics
NPI:1619483120
Name:SANCHEZ, BETHANY NOEL (RN,BSN)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:NOEL
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:NOEL
Other - Last Name:CATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:94 BEAUTY ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-1431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 BEAUTY ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-1431
Practice Address - Country:US
Practice Address - Phone:304-995-4953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV89024163W00000X
VA0001256816163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAW223367503OtherAETNA