Provider Demographics
NPI:1609288950
Name:MORRILL, BETHANY DIERKER (CCP)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:DIERKER
Last Name:MORRILL
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3212 BROOKHILL CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-4269
Mailing Address - Country:US
Mailing Address - Phone:205-999-5797
Mailing Address - Fax:205-592-5873
Practice Address - Street 1:800 MONTCLAIR RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1908
Practice Address - Country:US
Practice Address - Phone:205-592-5617
Practice Address - Fax:205-592-5873
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist