Provider Demographics
NPI:1124858535
Name:BALDWIN, BETHANY JOY (NP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOY
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:JOY
Other - Last Name:ABRESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:781 TAYLOR GROCERY RD
Mailing Address - Street 2:
Mailing Address - City:CADWELL
Mailing Address - State:GA
Mailing Address - Zip Code:31009-3341
Mailing Address - Country:US
Mailing Address - Phone:678-469-4813
Mailing Address - Fax:
Practice Address - Street 1:1826 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:478-272-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN250655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily