Bethany Racine, LPN
Individual provider Active NPI Licensed Practical Nurse · Gilbertville, MA
NPI 1114644663 · NPPES record last updated Oct 25, 2022
Key facts
- NPI
- 1114644663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LN101038 (MA)
- Practice address
- 72 Prospect St
Gilbertville, MA 01031-9704 - Phone
- (774) 230-4983
- NPI assigned
- Oct 25, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LN101038 | MA | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LN101038 | MA | Yes |
Addresses
Primary practice location
72 Prospect St
Gilbertville, MA 01031-9704
Mailing address
72 Prospect St
Gilbertville, MA 01031-9704
Phone (774) 230-4983
Other providers in Gilbertville, MA
All providers in Gilbertville, MA · Licensed Practical Nurse in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.