Healthcare Provider Details

I. General information

NPI: 1932013992
Provider Name (Legal Business Name): BRIDGET BETZIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

353 E MICHIGAN AVE
KALAMAZOO MI
49007-3844
US

IV. Provider business mailing address

353 E MICHIGAN AVE
KALAMAZOO MI
49007-3844
US

V. Phone/Fax

Practice location:
  • Phone: 269-910-2888
  • Fax:
Mailing address:
  • Phone: 269-910-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: