Bethel, Kenneth Scott

Bethel, Kenneth Scott is an individual health care provider with primary practice located at 236 Simpson Ave , Elkhart IN 46516-4666. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Bethel, Kenneth Scott can be contacted via phone (574) 293-0052.

Contact Information

Primary practice address
236 Simpson Ave Elkhart IN 46516-4666
Phone: (574) 293-0052
Fax: (574) 293-7635
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 28138800A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71003875A Indiana

Profile Details

NPI number 1194093807
LBN Legal business name Bethel, Kenneth Scott
Credentials RN, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2011
Last updated Nov 3rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194093807 NPPES
Indiana MEDICAID 201043130

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