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General NPI Number Information
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NPI Number | 1912272667
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Entity Type | Individual
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Provider Name | BETHANY ANN DANNER CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 301 DR CARTER BLVD
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City | BUNNELL
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State | FL
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Zip | 32110-6212
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Country | US
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Telephone | 386-313-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LUMBERJACK TRL
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City | PALM COAST
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State | FL
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Zip | 32137-9325
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Country | US
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Telephone | 443-517-7628
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11032244
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R108242
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 11032244
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License Number State | FL
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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 | R108242
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License Number State | MD
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