Provider Demographics
NPI:1356132443
Name:FARMER, BETHANY (RDN)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3991 DUTCHMANS LANE
Mailing Address - Street 2:MEDICAL PLAZA 2 - SUITE 310
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-472-1186
Mailing Address - Fax:502-899-6783
Practice Address - Street 1:3991 DUTCHMANS LANE
Practice Address - Street 2:MEDICAL PLAZA 2 - SUITE 310
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-899-6782
Practice Address - Fax:502-899-6783
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273732133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered