Bethany Duckert
Nurse Practitioner, Pediatrics in Rockford, IL. Individual provider (NPI-1).
NPI number1922847235
StatusActive
Last updated in NPPESMay 24, 2024
Details
- NPI
- 1922847235
- Entity type
- Individual (NPI-1)
- Name
- Bethany Duckert
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 24, 2024
- Certification date
- May 20, 2024
- Last updated
- May 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | 209.029730 | IL | Yes |
Practice location
1350 Charles StRockford, IL 61104
Phone 779-696-0600
Mailing address
4817 Poplar Creek DrMadison, WI 53718-2130
Phone 920-960-0223
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