Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 320090 | NY |
NPI | 1265834071 |
---|---|
Provider Name | Bethany Marie Denmon |
First Address | Binghamton, NY 13903-3304 |
Second Address | Binghamton, NY 13903-3304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2014 |
Last Update Date | 09/01/2017 |