Bethany R Fisk, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

4704278617 Issued in MI

Practice address

15146 16TH Ave
Marne, MI 49435-9605

Phone

(616) 520-9075

NPI assigned

Jun 1, 2022

Sex

Female

Sole proprietor

No

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1609515287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15146 16TH AVE",
            "city": "MARNE",
            "state": "MI",
            "postal_code": "494359605",
            "telephone_number": "616-520-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15146 16TH AVE",
            "city": "MARNE",
            "state": "MI",
            "postal_code": "494359605",
            "telephone_number": "616-520-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "BETHANY",
        "middle_name": "R",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704278617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Alana Boynton, LMSW
• Robert R. Braswell, MD
• Lyndsey Margaret Clark, NP
• Nina Johnson Deane, PMHNP
• Lee A Diener
• Hilary M Fowler, NP
• Sheryl Funston, NP-BC
• Green Castle Recovery Centers, LLC. (Sanford Comprehensive Treatment Eating Disorders)
• Delana Renee Hadden, LPC
• Jennifer Holshoe, CPM

• Adult Psychiatric/Mental Health Registered Nurse in Marne, MI
• Providers in Marne, MI by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.