Stack, Bethany Lynn
Stack, Bethany Lynn is an sole proprietor health care provider with primary practice located at 3 Albert Cree Dr , Rutland VT 05701-4601. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Stack, Bethany Lynn can be contacted via phone (802) 775-2937.Contact Information
Primary practice address
3 Albert Cree Dr
Rutland VT 05701-4601
Phone: (802) 775-2937
Fax: (802) 773-0934
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 055-0030670 | Vermont |
Profile Details
| NPI number | 1184619876 |
|---|---|
| LBN Legal business name | Stack, Bethany Lynn |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Mar 3rd, 2011 - about 13 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184619876 | NPPES |
| Vermont | Other | 00059907 | BCBS |
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