Provider Demographics
NPI:1699923961
Name:YOCHUM, BETHANY AMELIA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:AMELIA
Last Name:YOCHUM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BETHANY
Other - Middle Name:AMELIA
Other - Last Name:COTTRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-0372
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 HEALTH CENTER DR STE 401
Practice Address - Street 2:
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4648
Practice Address - Country:US
Practice Address - Phone:217-258-4020
Practice Address - Fax:217-258-4023
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-003295363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant