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General NPI Number Information
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NPI Number | 1841069374
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Entity Type | Individual
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Provider Name | BETHANY KONTAXES MS, CNS, LDN
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Gender | Female
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Dates
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Enumeration Date | 12/26/2023
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Last Update Date | 12/30/2023
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Provider Practice Location Address
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Address Line | 1047 ALLEGHENY AVE
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City | OIL CITY
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State | PA
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Zip | 16301-2670
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Country | US
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Telephone | 814-346-1673
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Fax |
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Provider Business Mailing Address
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Address Line | 458 HENDERSHOT RD
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City | KENNERDELL
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State | PA
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Zip | 16374-5824
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Country | US
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Telephone | 814-720-6445
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | DN008306
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN008306
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | DN008306
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License Number State | PA
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