| NPI | 1639835077 | 
|---|---|
| Former Name | BETHANY JO EIFRID | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71011832A) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71011832A) | 
| Enumeration Date | 2021-11-10 | 
| Last Update Date | 2025-05-12 |