Provider Demographics
NPI:1043891799
Name:BETHAY, SYBIL FERRIS (LPN)
Entity Type:Individual
Prefix:
First Name:SYBIL
Middle Name:FERRIS
Last Name:BETHAY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2199 HUNTER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-3780
Mailing Address - Country:US
Mailing Address - Phone:706-610-6610
Mailing Address - Fax:706-610-6601
Practice Address - Street 1:2199 HUNTER CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-3780
Practice Address - Country:US
Practice Address - Phone:706-610-6601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN050512164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse