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NPI Code Detail

MEDICARE: MISS BETTY ANN JOHANSEN RN,C,FNP

MEDICARE:  MISS BETTY ANN JOHANSEN  RN,C,FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner229039TX

General Provider Information

NPI Number : 1003938606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS BETTY ANN JOHANSEN RN,C,FNP
Provider Business Mailing Address
First Line : 3304 COLORADO BLVD STE 101
Second Line :
City : DENTON
State : TX
Zip : 76210-6872
Country : US
Telephone Number : 940-566-2358
Fax Number : 940-381-2613
Provider Business Practice Location Address
First Line : 3304 COLORADO BLVD STE 101
Second Line :
City : DENTON
State : TX
Zip : 76210-6872
Country : US
Telephone Number : 940-566-2358
Fax Number : 940-381-2613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 07/08/2007

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Directions to “ MISS BETTY ANN JOHANSEN RN,C,FNP” Practice Location

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