Provider Demographics
NPI:1043025786
Name:QUIGLEY, BETHANY (RN)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 WITTWER LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-5122
Mailing Address - Country:US
Mailing Address - Phone:702-423-2845
Mailing Address - Fax:
Practice Address - Street 1:1818 WITTWER LN
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:UT
Practice Address - Zip Code:84765-5122
Practice Address - Country:US
Practice Address - Phone:702-423-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-35442163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant