Healthcare Provider Details

I. General information

NPI: 1891214870
Provider Name (Legal Business Name): JOCELYN DENISE BETTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYN DENISE BETTS

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 GETTLER ST
DYER IN
46311-7702
US

IV. Provider business mailing address

9901 GETTLER ST
DYER IN
46311-7702
US

V. Phone/Fax

Practice location:
  • Phone: 708-897-5099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number041335385
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: