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General NPI Number Information
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NPI Number | 1124292578
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Entity Type | Individual
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Provider Name | GRETCHEN SOBERAY BETTS DO
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Gender | Female
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 5502 W BROADWAY AVE NORTHWEST FAMILY PHYSICIANS
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City | CRYSTAL
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State | MN
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Zip | 55428-3508
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Country | US
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Telephone | 763-504-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 5502 W BROADWAY AVE NORTHWEST FAMILY PHYSICIANS
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City | CRYSTAL
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State | MN
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Zip | 55428-3508
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Country | US
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Telephone | 763-504-6500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TP653
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2019031609
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301119382
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO-05412
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2020
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License Number State | NE
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11518
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License Number State | SD
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D02923
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License Number State | ME
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0062516
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License Number State | CO
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 299885
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License Number State | NY
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 51283
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License Number State | MN
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