BETHANNE FONDREN CARSON (NPI# 1780931154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780931154 |
| Entity Type | Individual |
| Full Name | BETHANNE FONDREN CARSON |
| Credential | PMHNP |
| Practice Address |
3560 Delaware St Suite 502 Beaumont TX 77706-3067 |
| Practice Telephone | 4098994472 |
| Practice Fax Number | 4098999795 |
| Mailing Telephone | 4098994472 |
| Mailing Fax Number | 4098999795 |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2017-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP122153 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3560 DELAWARE ST SUITE 502 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706-3067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071915 | Dave S. Carpenter | Dentist | 3560 Delaware St, Ste 1003, Beaumont, TX 77706-3026 | 2005-05-31 |
| 1780234229 | Morgan Mayeux | Pathology | 3560 Delaware St, Beaumont, TX 77706-3067 | 2019-09-17 |
| 1033634514 | Lindsey Kathleen Hullett | Internal Medicine | 3560 Delaware St, Beaumont, TX 77706-3067 | 2017-08-07 |
| 1508392317 | Reeti K Joshi, Md Pa | Internal Medicine | 3560 Delaware St, 301, Beaumont, TX 77706-3067 | 2017-05-11 |
| 1578947438 | Desiree Rice | Counselor | 3560 Delaware St, Suite 1205, Beaumont, TX 77706-3067 | 2015-07-10 |
| 1528482486 | Dexter Simmons | Physical Therapist | 3560 Delaware St, Suite# 301, Beaumont, TX 77706-3067 | 2014-02-13 |
| 1649510694 | Jeniffer Kay Esclovon | Counselor | 3560 Delaware St, Suite 502, Beaumont, TX 77706-3067 | 2013-02-27 |
| 1235486036 | Elyse Lynn Brack | Physician Assistant | 3560 Delaware St, Suite 901, Beaumont, TX 77706-3067 | 2012-08-10 |
| 1255686226 | Beaumont Smile Center, P.a. | Dentist | 3560 Delaware St, Suite 102, Beaumont, TX 77706-3067 | 2012-07-16 |
| 1033485669 | Morrell Dermatology, P.a. | Dermatology | 3560 Delaware St, Suite 901, Beaumont, TX 77706-3000 | 2012-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760969562 | Chrystanya A Adeniji | Nurse Practitioner | 514 N California Ave Ste 18, Beaumont, CA 92223-2120 | 2018-07-24 |
| 1295238632 | Melissa Lyn Tortorice | Nurse Practitioner | 3560 Delaware St Ste 502, Beaumont, TX 77706-3061 | 2018-03-12 |
| 1427334374 | Jt Seaman | Nurse Practitioner | 7090 Prutzman Rd, # 22, Beaumont, TX 77706-5823 | 2011-10-24 |
| 1548889116 | Bridgett Fisk | Nurse Practitioner | 3560 Delaware St Ste 207, Beaumont, TX 77706-3059 | 2020-04-13 |
| 1972934313 | Kelly Sparkman | Nurse Practitioner | 2750 S 8th St, Beaumont, TX 77701-7719 | 2013-12-11 |
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| 1750981619 | Suvekchya Subedi | Nurse Practitioner | 4032 Vista Mar Drive, Euless, TX 76040 | 2020-10-29 |
| 1821698754 | Christienne Felice Solis Callasan | Nurse Practitioner | 1010 Palos Verdes Blvd, Arlington, TX 76017-1780 | 2020-10-29 |
| 1932709201 | Aftercare, Pllc | Nurse Practitioner | 2000 Crawford St Ste 1221, Houston, TX 77002-9000 | 2020-10-27 |
| 1497355929 | Hector Medellin IIi | Nurse Practitioner | 6014 County Road 4068, Kemp, TX 75143-2600 | 2020-10-26 |
| 1639778947 | Aj Psychiatry Pllc | Nurse Practitioner | 1920 N Coit Rd Ste 219, Richardson, TX 75080-2832 | 2020-10-19 |
| 1154929735 | Valerie Michelle Vaughn-smith | Nurse Practitioner | 3105 Rockbrook Dr, Kilgore, TX 75662-2251 | 2020-10-15 |
| 1700483468 | Knd Behavioural Health Clinic | Nurse Practitioner | 103 Herrington Dr, Mansfield, TX 76063-7615 | 2020-10-06 |
| 1184231805 | Tihana Sladic | Nurse Practitioner | 1515 S Capital of Texas Hwy Ste 300&301, Austin, TX 78746-6579 | 2020-09-27 |
| 1679189369 | Charity Chioma Durant | Nurse Practitioner | 2310 Echo Ct, Rowlett, TX 75088-1534 | 2020-09-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.