Provider Demographics
NPI:1972102853
Name:MESSER, BETHANIE GRACE
Entity type:Individual
Prefix:
First Name:BETHANIE
Middle Name:GRACE
Last Name:MESSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 EARL VANCE DR
Mailing Address - Street 2:
Mailing Address - City:DINGESS
Mailing Address - State:WV
Mailing Address - Zip Code:25671-0200
Mailing Address - Country:US
Mailing Address - Phone:304-752-7986
Mailing Address - Fax:
Practice Address - Street 1:222 EARL VANCE DR
Practice Address - Street 2:
Practice Address - City:DINGESS
Practice Address - State:WV
Practice Address - Zip Code:25671-0200
Practice Address - Country:US
Practice Address - Phone:304-752-7986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant