| NPI | 1891112371 | 
|---|---|
| Former Name | BETHANNE SKIDMORE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9330137) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 643638) | 
| Enumeration Date | 2014-03-24 | 
| Last Update Date | 2014-03-24 |