=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871136887
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BETHANY STRINGER NMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2019
-----------------------------------------------------
Last Update Date | 01/30/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7515 E LONG LOOK DR
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314-5507
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-582-6447
-----------------------------------------------------
Fax | 928-499-3287
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7904 E CROOKED CREEK TRL
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314-1968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number | 19-1846
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------