Provider Demographics
NPI:1861828923
Name:GRUBER, BETHANY WOODRUFF (RN, BSN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:WOODRUFF
Last Name:GRUBER
Suffix:
Gender:F
Credentials:RN, BSN, NP-C
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:W
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, NP-C
Mailing Address - Street 1:73 SW PARK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BAXLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31513-2008
Mailing Address - Country:US
Mailing Address - Phone:912-705-8051
Mailing Address - Fax:912-705-8051
Practice Address - Street 1:73 SW PARK AVE
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0703
Practice Address - Country:US
Practice Address - Phone:912-705-8050
Practice Address - Fax:912-705-8051
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2025-10-15
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