Healthcare Provider Details

I. General information

NPI: 1710702733
Provider Name (Legal Business Name): COURTNEY KATHLEEN BETTINSON BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. COURTNEY KATHLEEN STARRETT

II. Dates (important events)

Enumeration Date: 11/15/2024
Last Update Date: 11/15/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 ARROWHEAD DR
EVANSTON WY
82930-9266
US

IV. Provider business mailing address

136 CITATION LN
EVANSTON WY
82930-5408
US

V. Phone/Fax

Practice location:
  • Phone: 307-789-3636
  • Fax:
Mailing address:
  • Phone: 307-679-7923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number27233
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: