Individual
BETHANY CRISCILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-FNP
Contact information
Practice address
115 SHETLAND LN, VERSAILLES, KY 40383-1701
(859) 421-7847
Mailing address
115 SHETLAND LN, VERSAILLES, KY 40383-1701
(859) 421-7847
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012878
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3012878
KENTUCKY BOARD OF NURSING
KY
Enumeration date
11/19/2018
Last updated
07/18/2023
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