Provider Demographics
NPI:1447867742
Name:RANKIN, BETHANY AUTUMN (NP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:AUTUMN
Last Name:RANKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:AUTUMN
Other - Last Name:COVINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2302 COUNTY ROAD 131
Mailing Address - Street 2:
Mailing Address - City:TUSCOLA
Mailing Address - State:TX
Mailing Address - Zip Code:79562-3216
Mailing Address - Country:US
Mailing Address - Phone:325-650-4948
Mailing Address - Fax:
Practice Address - Street 1:3101 S 27TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-6219
Practice Address - Country:US
Practice Address - Phone:325-704-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015319363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner