MEDICARE: MRS. SHARON LYNN BETTINGER P.A.

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
1	363AM0700X	Medical Physician Assistant	3085	AZ

General Provider Information

NPI Number	:	1134207277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON LYNN BETTINGER P.A.

Provider Business Mailing Address
First Line	:	18237 N 71ST DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-8104
Country	:	US
Telephone Number	:	602-978-4750
Fax Number	:

Provider Business Practice Location Address
First Line	:	34597 N 60TH ST
Second Line	:	SUITE 100
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-5240
Country	:	US
Telephone Number	:	480-473-7800
Fax Number	:	480-513-8704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	01/20/2010

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