Provider Demographics
NPI:1043053788
Name:WAGLER, BETHANY RUTH (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:RUTH
Last Name:WAGLER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 WALKER AENUE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-0001
Mailing Address - Country:US
Mailing Address - Phone:919-749-1632
Mailing Address - Fax:
Practice Address - Street 1:1007 WALKER AVENUE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412
Practice Address - Country:US
Practice Address - Phone:919-749-1632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC192946163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology