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General NPI Number Information
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NPI Number | 1386586089
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Entity Type | Individual
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Provider Name | BETHANY MARIE LOSO RN
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Gender | Female
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 4801 VETERANS DR
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2015
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Country | US
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Telephone | 320-252-1670
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Fax |
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Provider Business Mailing Address
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Address Line | 15120 OLD MILL RD
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City | SPICER
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State | MN
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Zip | 56288-9579
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R2159519
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License Number State | MN
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