Individual
BETHANY ANN WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
Mailing address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R877762
MS
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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