Healthcare Provider Details

I. General information

NPI: 1548422504
Provider Name (Legal Business Name): PATRICIA K BETTS CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 DOUGLAS ST NE SHAED ELEMENTARY SCHOOL
WASHINGTON DC
20003
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-576-6052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberRN26771
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: