Provider Demographics
NPI:1144844382
Name:HOCKENSMITH, BETHANY (PA)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:HOCKENSMITH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7906 NEW LAGRANGE ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-8706
Mailing Address - Country:US
Mailing Address - Phone:502-327-9233
Mailing Address - Fax:502-327-0666
Practice Address - Street 1:7906 NEW LAGRANGE ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-8706
Practice Address - Country:US
Practice Address - Phone:502-327-9233
Practice Address - Fax:502-327-0666
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2778363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty