Provider Demographics
NPI:1912207333
Name:LENGEL, BETHANY MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIE
Last Name:LENGEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-3569
Mailing Address - Fax:833-213-6428
Practice Address - Street 1:614 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-2003
Practice Address - Country:US
Practice Address - Phone:424-822-8324
Practice Address - Fax:866-230-8028
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily