Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP007400 | PA |
NPI | 1043210602 |
---|---|
Provider Name | Mrs. Bethann M Chadwick |
First Address | York, PA 17403-5160 |
Second Address | York, PA 17403-5160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 08/07/2007 |