Bethany A Rose, LPN
Individual provider Active NPI Licensed Practical Nurse · Medway, OH
NPI 1124774559 · NPPES record last updated Apr 29, 2025
Key facts
- NPI
- 1124774559
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- LPN.147701.MEDS-IV (OH)
- Practice address
- 9717 Lower Valley Pike
Medway, OH 45341-9749 - Phone
- (937) 450-3785
- NPI assigned
- Feb 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 147701 | OH | MD | Licensed Practical Nurse |
| LPN.147701.MEDS-IV | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN.147701.MEDS-IV | OH | Yes |
| Licensed Practical Nurse | 164W00000X | 147701 | OH |
Addresses
Primary practice location
9717 Lower Valley Pike
Medway, OH 45341-9749
Mailing address
9717 Lower Valley Pike
Medway, OH 45341-9749
Phone (937) 450-3785
Other providers in Medway, OH
- Garnet K.B. Holliday
- Kimberly Hutson
- Dawda Jawara
- Helen Marie Kiss
- Chandler Phillips
- Claudia Lee Shellabarger
- Michelle Renee Stafford
- Alicia Wagoner
- Wagoner'S Psychological Services, LLC
- Irene White
All providers in Medway, OH · Licensed Practical Nurse in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2025. 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.