Provider Demographics
NPI:1528436870
Name:GRIEVES, BETHANY
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:GRIEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9777 N THORNYDALE RD
Mailing Address - Street 2:APT 6106
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-5000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9777 N THORNYDALE RD
Practice Address - Street 2:APT 6106
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-5000
Practice Address - Country:US
Practice Address - Phone:520-377-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN131530163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool