Provider Demographics
NPI:1780018325
Name:RINE, BETHANY LYNN (DOULA)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:RINE
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 N OAKLAND AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1653
Mailing Address - Country:US
Mailing Address - Phone:479-684-6823
Mailing Address - Fax:
Practice Address - Street 1:1340 N OAKLAND AVE APT 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1653
Practice Address - Country:US
Practice Address - Phone:479-684-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula