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General NPI Number Information
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NPI Number | 1780208686
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Entity Type | Organization
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Legal Business Name | BETHANY HEALTH SERVICES
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 10 BENNING ST STE 160 #208
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City | WEST LEBANON
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State | NH
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Zip | 03784-3402
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Country | US
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Telephone | 603-601-4766
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Fax | 603-506-6362
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Provider Business Mailing Address
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Address Line | 10 BENNING ST STE 160
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City | WEST LEBANON
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State | NH
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Zip | 03784-3402
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Country | US
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Telephone | 603-601-4766
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Fax | 603-506-6362
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Authorized Official
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Title or Position | NP
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Name | DR. VANNESSA DAVIS
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Credential | DNP, APRN
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Telephone | 603-601-4766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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