Provider Demographics
NPI:1356394241
Name:GLOTFELTY, BETHANY CRITTENDON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:CRITTENDON
Last Name:GLOTFELTY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1305 ESCALANTE DR SUITE 204
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-8932
Mailing Address - Country:US
Mailing Address - Phone:970-385-4022
Mailing Address - Fax:970-385-4337
Practice Address - Street 1:1305 ESCALANTE DR SUITE 204
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-8932
Practice Address - Country:US
Practice Address - Phone:970-385-4022
Practice Address - Fax:970-385-4337
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2013-0028363AM0700X
COPA0003731363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKQ67890Medicare UPIN
AK160662Medicare ID - Type Unspecified