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General NPI Number Information
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NPI Number | 1457066110
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Entity Type | Individual
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Provider Name | BETHANY KAITLYN CARR APRN
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Gender | Female
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 5151 N 9TH AVE
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City | PENSACOLA
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State | FL
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Zip | 32504-8721
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Country | US
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Telephone | 850-416-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 9127 TARA CIR
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City | MILTON
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State | FL
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Zip | 32583-4150
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Country | US
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Telephone | 850-816-9694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9470896
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN11035285
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License Number State | FL
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