Physician Compare National (NPI:1831579655)

HEALTHCARE PROVIDER: KAITLYN BETHUNE FNP-BC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831579655
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860707890
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171115002257
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BETHUNE
	Individual professional last name
Provider First Name	KAITLYN
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3051 VALLEY AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 108
	Group Practice or individual's line 2 address
City	WINCHESTER
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	226012658
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WINCHESTER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	510008
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BERKELEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490033
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WARREN MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	511309
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WAR MEMORIAL HOSPITAL INC
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y