Provider Demographics
NPI:1316480817
Name:SEIFERT, BETHNEY ANNE (APRN)
Entity type:Individual
Prefix:
First Name:BETHNEY
Middle Name:ANNE
Last Name:SEIFERT
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 COLUMBIA ST STE 11
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6331
Mailing Address - Country:US
Mailing Address - Phone:074-850-8199
Mailing Address - Fax:877-284-1946
Practice Address - Street 1:50 COLUMBIA ST STE 11
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6331
Practice Address - Country:US
Practice Address - Phone:407-850-8199
Practice Address - Fax:877-284-1946
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV002412363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily