| NPI | 1285883306 |
|---|---|
| Former Name | HEATHER DAWN BETHKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179500) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 164W00000X Licensed Practical Nurse (Licence: CA VN 232939) | |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2022-04-21 |