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NPI Code Detail

MEDICARE: BETHANY H ALLEN CNP

MEDICARE:   BETHANY H ALLEN  CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse2313481MN
2363LA2200XAdult Health Nurse Practitioner4804MN

General Provider Information

NPI Number : 1184172066
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY H ALLEN CNP
Provider Business Mailing Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 612-262-9000
Fax Number :
Provider Business Practice Location Address
First Line : 2800 HENNEPIN AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1906
Country : US
Telephone Number : 612-775-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2016
Last Update Date : 05/05/2026

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