Provider Demographics
NPI:1972312148
Name:SMITH, BETHANY SKYE (CRNP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:SKYE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 COUNTY ROAD 1169
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35057-0729
Mailing Address - Country:US
Mailing Address - Phone:205-471-2989
Mailing Address - Fax:
Practice Address - Street 1:1935 AL HIGHWAY 157 STE C
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1862
Practice Address - Country:US
Practice Address - Phone:256-297-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-180173363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily