Bethann Mallon, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP022007 Issued in PA

Practice address

830 Penllyn Blue Bell Pike
Blue Bell, PA 19422-1670

Phone

(610) 222-9000

NPI assigned

Jun 5, 2020

Last updated

Dec 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1598389496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PENLLYN BLUE BELL PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221670",
            "telephone_number": "610-222-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PENLLYN BLUE BELL PIKE",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194221670",
            "telephone_number": "610-222-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLON",
        "first_name": "BETHANN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP022007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Marie Lynch, OTR/L
• Megan R Macdonnell, PSYD
• Marquita Mack, LICENSED PRACTICAL N
• Samuel Joseph Magliente, DC
• Marie Veronica Maguire, PA LCSW
• Amber Mallonee, MS, OTR/L
• Christine Anne Malloy, M.D.
• Malvern Community Health Services Inc.
• John Mangan III, MD
• Cara Rose Maniloff, MA, CF-SLP

• Adult Health Nurse Practitioner in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.