MEDICARE: BRIANA MICHELLE BETHEA

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	374U00000X	Home Health Aide
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1972895498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANA MICHELLE BETHEA

Provider Business Mailing Address
First Line	:	2504 DUNAWAY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2501
Country	:	US
Telephone Number	:	513-488-3498
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 DUNAWAY CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2501
Country	:	US
Telephone Number	:	513-488-3498
Fax Number	:

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

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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Directions to “ BRIANA MICHELLE BETHEA ” Practice Location

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