Provider Demographics
NPI:1689337651
Name:KNIGHTON, BETHANY (CPM)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:KNIGHTON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 E 300 N
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2308
Mailing Address - Country:US
Mailing Address - Phone:208-241-6995
Mailing Address - Fax:
Practice Address - Street 1:5319 S 500 E
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4773
Practice Address - Country:US
Practice Address - Phone:801-436-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife