Healthcare Provider Details

I. General information

NPI: 1306233051
Provider Name (Legal Business Name): BETHANY GRACE BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 W NEWPORT RD
LITITZ PA
17543-7774
US

IV. Provider business mailing address

334 HARTMAN BRIDGE ROAD
RONKS PA
17572
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-2108
  • Fax: 717-627-2434
Mailing address:
  • Phone: 717-883-1123
  • Fax: 717-983-4722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP014857
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: