BETHANY WILLIS (NPI# 1487904686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487904686 |
| Entity Type | Individual |
| Full Name | BETHANY WILLIS |
| Credential | IBCLC |
| Practice Address |
2114 Spring Dr Haynesville LA 71038-5518 |
| Practice Telephone | 3186242243 |
| Mailing Telephone | 3186242243 |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174N00000X | Lactation Consultant, Non-RN | 11192214 | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962835033 | Bethany A. Willis | Physical Therapist | 26908 Detroit Rd Ste 200, Westlake, OH 44145-2399 | 2013-08-13 |
| 1619113420 | Bethany D'aun Willis | Marriage & Family Therapist | 720 14th Avenue, Longview, WA 98632 | 2008-12-29 |
| Street Address |
2114 SPRING DR |
| City | HAYNESVILLE |
| State | LA |
| Zip Code | 71038-5518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396848834 | Eddy Waller Sherman II | Dentist | 9915 Hwy 79, Haynesville, LA 71038 | 2006-09-07 |
| 1801388921 | Dan Thomas Ware | Pharmacist | 1866 Main St, Haynesville, LA 71038-4904 | 2018-06-04 |
| 1538288113 | Ted S Pharmacy LLC | Pharmacy | 1866 Main St, Haynesville, LA 71038-4904 | 2007-03-28 |
| 1366582983 | Ted's Pharmacy | Pharmacist | 1866 Main St, Haynesville, LA 71038-4904 | 2007-02-07 |
| 1902114473 | David M Beaird | Pharmacist | 1863 Main St, Haynesville, LA 71038-4905 | 2010-09-18 |
| 1639101678 | Freds Stores of Tennessee Inc | Pharmacy | 9720 Highway 79, Haynesville, LA 71038-4905 | 2006-07-07 |
| 1912903964 | David Raines Community Health Center, Inc | Clinic/Center | 1953 Main St, Haynesville, LA 71038-4907 | 2005-06-23 |
| 1104197250 | Sandra Killgore Meisler | Pharmacist | 1909 Main St, Haynesville, LA 71038-4907 | 2012-01-21 |
| 1477601946 | James K Killgore Inc | Pharmacy | 1909 Main St, Haynesville, LA 71038-4907 | 2007-01-08 |
| 1275165862 | Jacinda Meadors | Clinic/Center | 1059 Mcdonald St, Haynesville, LA 71038-5235 | 2020-02-11 |
| Find all providers in zip 71038 | ||||
| Taxonomy Code | 174N00000X |
| Grouping | Other Service Providers |
| Classification | Lactation Consultant, Non-RN |
| An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization. |
| Notes: Source: National Uniform Claim Committee [1/1/2011: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912462615 | Tamiqua Monique Torres | Lactation Consultant, Non-RN | 4129 Idaho Ave #a, Kenner, LA 70065 | 2019-02-06 |
| 1568946630 | Clair Hollins Mccoy | Lactation Consultant, Non-RN | 9363 Pecan Tree Dr, Baton Rouge, LA 70810-0700 | 2018-09-24 |
| 1659885580 | Chelsey Lee Leruth | Lactation Consultant, Non-RN | 2121 Octavia St, New Orleans, LA 70115-5655 | 2017-11-30 |
| 1285158121 | Evon Marie Lavergne | Lactation Consultant, Non-RN | 1412 Sunset Dr, Lake Charles, LA 70607-3634 | 2017-08-02 |
| 1942748058 | Christen Anders | Lactation Consultant, Non-RN | 4865 Sweetbriar St, Baton Rouge, LA 70808-8660 | 2017-02-09 |
| 1881139707 | Kristian Billiot | Lactation Consultant, Non-RN | 122 Cawthorn Dr, Slidell, LA 70458-1554 | 2017-01-01 |
| 1801495296 | Candyse Anne Matassa | Lactation Consultant, Non-RN | 5848 Menlo Dr, Baton Rouge, LA 70808-5047 | 2020-10-18 |
| 1649828310 | Courtney Lee Deitch | Lactation Consultant, Non-RN | 1727 Imperial Blvd Bldg 3, Lake Charles, LA 70605-5393 | 2019-08-27 |
| 1447768312 | Jana Suzanne Mcdonald | Lactation Consultant, Non-RN | 5027 Paris Ave, New Orleans, LA 70122-2538 | 2018-01-12 |
| City | HAYNESVILLE |
| Zip Code | 71038 |
Please comment or provide details below to improve the information on BETHANY WILLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.