Healthcare Provider Details

I. General information

NPI: 1841443728
Provider Name (Legal Business Name): BETHANY L MCCAULEY AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MCNAUGHTEN RD STE 200
COLUMBUS OH
43213-5111
US

IV. Provider business mailing address

85 MCNAUGHTEN RD STE 200
COLUMBUS OH
43213-5111
US

V. Phone/Fax

Practice location:
  • Phone: 614-627-2000
  • Fax:
Mailing address:
  • Phone: 614-627-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberNS-10246
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number021879
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: