Provider Demographics
NPI:1982443735
Name:HURON, BETHANY LYNN
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:HURON
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 1:602 VAN EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-2469
Mailing Address - Country:US
Mailing Address - Phone:330-801-2810
Mailing Address - Fax:
Practice Address - Street 1:602 VAN EVERETT AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-2469
Practice Address - Country:US
Practice Address - Phone:330-801-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker