MEDICARE: MS. TOMISHA YVON BETHUNE CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.020564	OH

General Provider Information

NPI Number	:	1043522089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TOMISHA YVON BETHUNE CNP

Provider Business Mailing Address
First Line	:	8055 MAYFIELD RD
Second Line	:	STE 105
City	:	CHESTERLAND
State	:	OH
Zip	:	44026-2447
Country	:	US
Telephone Number	:	440-214-8027
Fax Number	:	216-201-8173

Provider Business Practice Location Address
First Line	:	1302 WINSTON RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-2516
Country	:	US
Telephone Number	:	216-374-8672
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2010
Last Update Date	:	08/07/2024

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