Bethany Grace Avila Otte, FNP-C
Nurse Practitioner, Primary Care in Beverly, MA. Individual provider (NPI-1).
NPI number1194265744
StatusActive
Last updated in NPPESJun 30, 2025
Details
- NPI
- 1194265744
- Entity type
- Individual (NPI-1)
- Name
- Bethany Grace Avila Otte
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 1, 2017
- Certification date
- Jun 30, 2025
- Last updated
- Jun 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | RN2367980 | MA | Yes |
| 163W00000X | Registered Nurse | 95104464 | CA | |
| 363LP2300X | Nurse Practitioner, Primary Care | 95006063 | CA |
Practice location
152 Conant St Ste 200Beverly, MA 01915-1659
Phone 978-922-2226
Mailing address
152 Conant St Ste 200Beverly, MA 01915-1659
Phone 978-922-2226 · Fax 978-922-2269
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