Provider Demographics
NPI:1447800529
Name:ERBY, BETHANY (CBS, CHD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:ERBY
Suffix:
Gender:F
Credentials:CBS, CHD
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:BRANCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MIDWIFE
Mailing Address - Street 1:6264 BRAYDEN WAY
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-5335
Mailing Address - Country:US
Mailing Address - Phone:214-836-3203
Mailing Address - Fax:
Practice Address - Street 1:6264 BRAYDEN WAY
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-5335
Practice Address - Country:US
Practice Address - Phone:214-836-3203
Practice Address - Fax:260-572-3473
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-19
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172V00000X, 175M00000X
GA174H00000X, 374J00000X
MDB5645B811C174N00000X
OK175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula