Provider Demographics
NPI:1255806428
Name:HJELLE, BETHANY ANNE (CNP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:ANNE
Last Name:HJELLE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9825 HOSPITAL DR STE 205
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4480
Mailing Address - Country:US
Mailing Address - Phone:763-587-7000
Mailing Address - Fax:763-587-7015
Practice Address - Street 1:9825 HOSPITAL DR STE 205
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4480
Practice Address - Country:US
Practice Address - Phone:763-587-7000
Practice Address - Fax:763-587-7015
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN6225363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology