MEDICARE: BETHANY S LACHENEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0001236172	VA
2	363LF0000X	Family Nurse Practitioner	35279	TN
3	363LA2100X	Acute Care Nurse Practitioner	0024176164	VA
4	363L00000X	Nurse Practitioner	0024176164	VA
5	363L00000X	Nurse Practitioner	432000	NY
6	363L00000X	Nurse Practitioner	71017548A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336638345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY S LACHENEY NP

Provider Business Mailing Address
First Line	:	724 BRISTOL VILLAGE DR APT 302
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-4636
Country	:	US
Telephone Number	:	804-426-4519
Fax Number	:

Provider Business Practice Location Address
First Line	:	5665 NEW NORTHSIDE DR STE 320
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328
Country	:	US
Telephone Number	:	770-874-5408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2018
Last Update Date	:	05/13/2026

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Directions to “ BETHANY S LACHENEY NP” Practice Location

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