Pavon, Bethany Carol
Pavon, Bethany Carol is an individual health care provider with primary practice located at 802 W King St Ste M , Owosso MI 48867-2100. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pavon, Bethany Carol can be contacted via phone (989) 729-4100.Contact Information
Primary practice address
802 W King St Ste M
Owosso MI 48867-2100
Phone: (989) 729-4100
Fax: (989) 729-4066
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 4704266187 | Michigan |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4704266187 | Michigan |
Profile Details
| NPI number | 1619374808 |
|---|---|
| LBN Legal business name | Pavon, Bethany Carol |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 3rd, 2014 |
| Last updated | Sep 11th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619374808 | NPPES |
| Michigan | MEDICAID | 1619374808 |
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