Individual
GRACE ELIZABETH BETHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 GANDY ST NE, RUSSELLVILLE, AL 35653-1911
(256) 381-6963
Mailing address
306 CENTER POINT LN, FLORENCE, AL 35634-2012
(901) 692-4496
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-159728
AL
363L00000X
Nurse Practitioner
Primary
1-159728
AL
Other
Enumeration date
11/17/2019
Last updated
03/29/2023
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