Pavon, Bethany Carol

Pavon, Bethany Carol is an individual health care provider with primary practice located at 802 W King St Ste M , Owosso MI 48867-2100. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Pavon, Bethany Carol can be contacted via phone (989) 729-4100.

Contact Information

Primary practice address
802 W King St Ste M Owosso MI 48867-2100
Phone: (989) 729-4100
Fax: (989) 729-4066
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704266187 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704266187 Michigan

Profile Details

NPI number 1619374808
LBN Legal business name Pavon, Bethany Carol
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2014
Last updated Sep 11th, 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 1619374808 NPPES
Michigan MEDICAID 1619374808

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