Healthcare Provider Details

I. General information

NPI: 1134486871
Provider Name (Legal Business Name): BETTY JEAN ARMEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 COLONIAL DR COTTAGES B & C
COLUMBIA SC
29203-6827
US

IV. Provider business mailing address

2108 SETH WILLIAMS BLVD
CAMP LEJEUNE NC
28547-1301
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-0123
  • Fax:
Mailing address:
  • Phone: 540-230-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number093401
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: