Healthcare Provider Details

I. General information

NPI: 1992486187
Provider Name (Legal Business Name): BETHANY BRIANNE ESTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10048 STURGEON LN
CINCINNATI OH
45251-1733
US

IV. Provider business mailing address

10048 STURGEON LN
CINCINNATI OH
45251-1733
US

V. Phone/Fax

Practice location:
  • Phone: 513-297-8351
  • Fax:
Mailing address:
  • Phone: 513-297-8351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-149441
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: