Provider Demographics
NPI:1972895498
Name:BETHEA, BRIANA MICHELLE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:MICHELLE
Last Name:BETHEA
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 1:2504 DUNAWAY CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2501
Mailing Address - Country:US
Mailing Address - Phone:513-488-3498
Mailing Address - Fax:
Practice Address - Street 1:2504 DUNAWAY CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2501
Practice Address - Country:US
Practice Address - Phone:513-488-3498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker