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General NPI Number Information
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NPI Number | 1063243210
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Entity Type | Individual
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Provider Name | BETHANY LOUISE DEWKETT APRN
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Gender | Female
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Dates
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Enumeration Date | 08/09/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-7256
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Fax |
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Provider Business Mailing Address
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Address Line | 114 CHALK POND RD
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City | NEWBURY
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State | NH
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Zip | 03255-6014
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Country | US
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Telephone | 603-731-5438
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 058103-21
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 058103-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 058103-23
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License Number State | NH
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