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Individual

BETHANY GAULTNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
40 OKATIE CTR BLVD STE 215, OKATIE, SC 29909-7507
(256) 453-6074
Mailing address
131 HORIZON TRL, BLUFFTON, SC 29910-4415
(843) 603-4800

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
21590
SC
363L00000X
Nurse Practitioner
RN272112
GA

Other

Enumeration date
01/22/2018
Last updated
11/02/2022
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