Provider Demographics
NPI:1164022380
Name:COLE, BETHANY LYNN (RN)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:LYNN
Last Name:COLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 ROWDY DR
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-8561
Mailing Address - Country:US
Mailing Address - Phone:936-404-8122
Mailing Address - Fax:
Practice Address - Street 1:501 ROWDY DR
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-8561
Practice Address - Country:US
Practice Address - Phone:936-404-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX971214163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics