Bethany Mitchell Braddock, APRN, FNP-C

Individual provider Active NPI Family Nurse Practitioner · Columbia, LA

NPI 1023939592 · NPPES record last updated Jul 22, 2026

Key facts

NPI
1023939592
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
248279 (LA)
Practice address
484 Collins Rd
Columbia, LA 71418-3388
Phone
(318) 649-5300
NPI assigned
Jul 22, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 248279 LA Yes

Addresses

Primary practice location

484 Collins Rd
Columbia, LA 71418-3388

Mailing address

472 Liberty Cemetary Rd
Grayson, LA 71435-4813

Other providers in Columbia, LA

All providers in Columbia, LA · Family Nurse Practitioner in Louisiana

Sources for this page

Verify at the official NPI Registry.