Healthcare Provider Details

I. General information

NPI: 1629953914
Provider Name (Legal Business Name): BETSY SCULLY GENTHNER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 LIFELINE RD STE 201
STROUDSBURG PA
18360-6473
US

IV. Provider business mailing address

77 S COMMERCE WAY
BETHLEHEM PA
18017-8891
US

V. Phone/Fax

Practice location:
  • Phone: 484-658-5437
  • Fax:
Mailing address:
  • Phone: 484-526-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031260
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: