Provider Demographics
NPI:1477052876
Name:WHITSON, BETHANY (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:WHITSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:COLLINS
Other - Last Name:WHITSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:27 W TOWNSHIP ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2821
Mailing Address - Country:US
Mailing Address - Phone:479-480-6677
Mailing Address - Fax:
Practice Address - Street 1:27 W TOWNSHIP ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2821
Practice Address - Country:US
Practice Address - Phone:479-480-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP10981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily