NP Bethany LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

NP BETHANY LLC

Practice address

1520 E Pima St
Phoenix, AZ 85034-4639

Phone

(602) 407-6280

NPI assigned

Apr 6, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bethany Fetzer, DNP, FNP-C, PMHNP-BC

Title

Owner

Phone

(815) 608-9277

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1205465770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 E HAMPTON AVE UNIT 1102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096301",
            "telephone_number": "815-608-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E PIMA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850344639",
            "telephone_number": "602-407-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NP BETHANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "FETZER",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-608-9277",
        "authorized_official_credential": "DNP, FNP-C, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.