Provider Demographics
NPI:1013635317
Name:FIELD, BETHANY ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:ANN
Last Name:FIELD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:ANN
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7439 FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-3600
Mailing Address - Country:US
Mailing Address - Phone:215-333-9484
Mailing Address - Fax:
Practice Address - Street 1:7439 FRANKFORD AVE STE 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-3636
Practice Address - Country:US
Practice Address - Phone:215-333-9484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026149363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily