Provider Demographics
NPI:1861828923
Name:ATKINS, BETHANY WOODRUFF (RN, BSN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:WOODRUFF
Last Name:ATKINS
Suffix:
Gender:F
Credentials:RN, BSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-0161
Mailing Address - Country:US
Mailing Address - Phone:912-375-3095
Mailing Address - Fax:
Practice Address - Street 1:209 S TALLAHASSEE ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6025
Practice Address - Country:US
Practice Address - Phone:912-375-3095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204317163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily