Healthcare Provider Details

I. General information

NPI: 1639107592
Provider Name (Legal Business Name): BETSY BATEJAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 VINE ST 7TH FL
PHILADELPHIA PA
19102-1031
US

IV. Provider business mailing address

609 W GERMANTOWN PIKE STE 220
EAST NORRITON PA
19403-4261
US

V. Phone/Fax

Practice location:
  • Phone: 215-762-7824
  • Fax: 215-246-5257
Mailing address:
  • Phone: 484-622-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW008584L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: