MEDICARE: BETHANN SINGREY

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
1	164W00000X	Licensed Practical Nurse	PN109630	OH

General Provider Information

NPI Number	:	1710337795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANN SINGREY

Provider Business Mailing Address
First Line	:	16134 DIVELBISS RD
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-8737
Country	:	US
Telephone Number	:	740-399-8025
Fax Number	:	740-397-1582

Provider Business Practice Location Address
First Line	:	16134 DIVELBISS RD
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-8737
Country	:	US
Telephone Number	:	740-399-8025
Fax Number	:	740-397-1582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	07/01/2016

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Directions to “ BETHANN SINGREY ” Practice Location

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