Provider Demographics
NPI:1982401022
Name:KALIN, BETHANY MARIE
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MARIE
Last Name:KALIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N 34TH ST APT 18
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-0688
Mailing Address - Country:US
Mailing Address - Phone:712-371-9993
Mailing Address - Fax:
Practice Address - Street 1:3604 SUMMIT PLAZA DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1065
Practice Address - Country:US
Practice Address - Phone:712-371-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist