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General NPI Number Information
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NPI Number | 1144262791
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Entity Type | Individual
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Provider Name | BETHANY L. JARVIS FNP
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Gender | Female
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 09/28/2015
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Provider Practice Location Address
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Address Line | 248 STATE ST SUITE 3A
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City | ELLSWORTH
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State | ME
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Zip | 04605-1850
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Country | US
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Telephone | 207-812-7031
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Fax | 207-660-4203
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Provider Business Mailing Address
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Address Line | PO BOX 587
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City | AUGUSTA
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State | ME
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Zip | 04332-0587
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Country | US
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Telephone | 207-509-3271
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Fax | 207-509-3271
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP81355
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN28734
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License Number State | ME
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