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NPI Code Detail

MEDICARE: BETH METTES FNP-BC

MEDICARE:   BETH  METTES  FNP-BC
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
1207Q00000XFamily Medicine Physician2018028689MO
2363LF0000XFamily Nurse Practitioner2018028689MO

General Provider Information

NPI Number : 1487132056
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH METTES FNP-BC
Provider Business Mailing Address
First Line : 31692 STATE HIGHWAY DD
Second Line :
City : MACON
State : MO
Zip : 63552-3119
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 307 MCKAY ST
Second Line :
City : MACON
State : MO
Zip : 63552-2029
Country : US
Telephone Number : 660-385-3141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2018
Last Update Date : 10/27/2022

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Directions to “ BETH METTES FNP-BC” Practice Location

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