Provider Demographics
NPI:1245997956
Name:HERRERA, BETHANY RENFRO (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:RENFRO
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 TWIN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-5738
Mailing Address - Country:US
Mailing Address - Phone:817-228-0507
Mailing Address - Fax:
Practice Address - Street 1:706 EUREKA ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-6520
Practice Address - Country:US
Practice Address - Phone:817-599-7373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily