Individual
BETHANY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
29653 ANCHOR CROSS BLVD, DAPHNE, AL 36526-9594
(251) 625-6896
(251) 625-6897
Mailing address
29653 ANCHOR CROSS BLVD, DAPHNE, AL 36526-9594
(251) 625-6896
(251) 625-6897
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-148719
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
240803
—
AL
01
—
A07842B
MEDICARE PTAN
AL
01
—
P02566941
RAILROAD MEDICARE
AL
Enumeration date
08/16/2019
Last updated
10/27/2021
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