Healthcare Provider Details

I. General information

NPI: 1952325003
Provider Name (Legal Business Name): MRS. BETSY NORTON ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. BETSY A NORTON

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 CUMMINGS ST
ABINGDON VA
24210-3207
US

IV. Provider business mailing address

329 CUMMINGS ST
ABINGDON VA
24210-3207
US

V. Phone/Fax

Practice location:
  • Phone: 276-628-9970
  • Fax: 276-628-9937
Mailing address:
  • Phone: 276-628-9970
  • Fax: 276-628-9937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number1101001369
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: