Provider Demographics
NPI:1861023541
Name:BETHUNE, SEKINAH YASMINE (CNA)
Entity Type:Individual
Prefix:
First Name:SEKINAH
Middle Name:YASMINE
Last Name:BETHUNE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 31ST ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-2542
Mailing Address - Country:US
Mailing Address - Phone:727-336-7249
Mailing Address - Fax:
Practice Address - Street 1:1720 31ST ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-2542
Practice Address - Country:US
Practice Address - Phone:727-336-7249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235658376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker