Provider Demographics
NPI:1194917997
Name:MCGUIRE, BETHANY J (APN)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:J
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:J
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:201 JORDAN RD
Mailing Address - Street 2:STE 200
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-4495
Mailing Address - Country:US
Mailing Address - Phone:615-966-6305
Mailing Address - Fax:615-966-7066
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:615-921-3920
Practice Address - Fax:615-656-7865
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341383Medicaid
TN3341383Medicaid