Healthcare Provider Details

I. General information

NPI: 1568224079
Provider Name (Legal Business Name): BETHANY ARIEL NORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 N MITCHELL AVE
BAKERSVILLE NC
28705-6502
US

IV. Provider business mailing address

PO BOX 27
BAKERSVILLE NC
28705-0027
US

V. Phone/Fax

Practice location:
  • Phone: 828-688-2104
  • Fax: 844-772-0832
Mailing address:
  • Phone: 828-688-2104
  • Fax: 844-772-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019520
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019520
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: