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NPI Code Detail

MEDICARE: MRS. BETHANY MARIE COLLOP FNP-C

MEDICARE:  MRS. BETHANY MARIE COLLOP  FNP-C
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
1363LF0000XFamily Nurse Practitioner1149791TX

General Provider Information

NPI Number : 1396516894
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETHANY MARIE COLLOP FNP-C
Provider Business Mailing Address
First Line : 2000 COLINA CV
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7867
Country : US
Telephone Number : 817-966-6767
Fax Number :
Provider Business Practice Location Address
First Line : 12171 W PARMER LN STE 102
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7362
Country : US
Telephone Number : 817-966-6767
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2024
Last Update Date : 01/12/2024

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Directions to “ MRS. BETHANY MARIE COLLOP FNP-C” Practice Location

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