Provider Demographics
NPI:1831906221
Name:MCCLAIN, BETHANY (RN)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6799 E DUBLIN PIKE
Mailing Address - Street 2:
Mailing Address - City:STRAUGHN
Mailing Address - State:IN
Mailing Address - Zip Code:47387-9707
Mailing Address - Country:US
Mailing Address - Phone:765-277-2605
Mailing Address - Fax:
Practice Address - Street 1:1100 REID PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-983-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28277335A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse