MEDICARE: MRS. BETHANY ERIN GEORGE NP

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	2000147960	MO

General Provider Information

NPI Number	:	1780656066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETHANY ERIN GEORGE NP

Provider Business Mailing Address
First Line	:	300 BARR HARBOR DR
Second Line	:	STE 50
City	:	WEST CONSHOHOCKEN
State	:	PA
Zip	:	19428-2998
Country	:	US
Telephone Number	:	866-825-3227
Fax Number	:

Provider Business Practice Location Address
First Line	:	5314 NW 64TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-2414
Country	:	US
Telephone Number	:	866-825-3227
Fax Number	:

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

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	07/08/2007

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