Bethany Willis, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

11192214

Practice address

2114 Spring Dr
Haynesville, LA 71038-5518

Phone

(318) 624-2243

NPI assigned

Sep 14, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1487904686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 SPRING DR",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710385518",
            "telephone_number": "318-624-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 SPRING DR",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710385518",
            "telephone_number": "318-624-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BETHANY",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "11192214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Springhill Medical Services, Inc. (Butler-Abshire Medical Clinic)
• Ted S Pharmacy LLC (Ted's Pharmacy)
• Ted's Pharmacy
• Tri-State Health Services of Cenla, LLC (Heritage Nursing Center)
• Dan Thomas Ware, RPH
• WK Butler-Abshire Medical Clinic

• Lactation Consultant (Non-RN) in Haynesville, LA
• Providers in Haynesville, LA by specialty
• Lactation Consultant (Non-RN) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.