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General NPI Number Information
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NPI Number | 1558047829
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Entity Type | Individual
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Provider Name | BETHANY RUTH JOHNSON MS, CGC
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Gender | Female
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 3900 KRESGE WAY STE 43
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City | LOUISVILLE
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State | KY
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Zip | 40207-4681
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Country | US
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Telephone | 502-928-3012
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 S HETTEMA ST
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City | YUMA
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State | AZ
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Zip | 85364-4317
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Country | US
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Telephone | 928-750-2443
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State |
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