Individual
BETHANY WHEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 CRUMS LN, LOUISVILLE, KY 40216-4231
(502) 589-8915
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2043862
KY
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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