Bethany Renee Moore, RN
Individual provider Active NPI School Registered Nurse · Williamson, NY
NPI 1144501958 · NPPES record last updated Sep 7, 2011
Key facts
- NPI
- 1144501958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- 424584 (NY)
- Practice address
- 5891 Route 21
Williamson, NY 14589-9102 - Phone
- (315) 589-9625
- NPI assigned
- Sep 7, 2011
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 424584 | NY | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 424584 | NY | Yes |
Addresses
Primary practice location
5891 Route 21
Williamson, NY 14589-9102
Mailing address
5891 Route 21
Williamson, NY 14589-9102
Phone (315) 589-9625
Other providers in Williamson, NY
- Irshad A Merkand
- Michael a. Herbert. DDS
- Jennifer Lee Miller
- Michael Brandon Miller
- Hope J Monje
- Hayley Katherine Musclow
- Chasity Jacquel Myrthil
- Stephen M Nothnagle
- Pratyusha Nunna
- Samantha Marie Oberdorf
All providers in Williamson, NY · School Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2011. 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.