Provider Demographics
NPI:1447036082
Name:PURTELL, BETHANY SUZANNE (MSN, APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:SUZANNE
Last Name:PURTELL
Suffix:
Gender:F
Credentials:MSN, APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 AVIATOR CT STE 100
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-9474
Mailing Address - Country:US
Mailing Address - Phone:937-546-9029
Mailing Address - Fax:
Practice Address - Street 1:600 AVIATOR CT STE 100
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-9474
Practice Address - Country:US
Practice Address - Phone:937-208-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0034856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily