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General NPI Number Information
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NPI Number | 1417327461
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Entity Type | Individual
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Provider Name | NICOLE BETTS AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1310 FORTINO BLVD STE D
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City | PUEBLO
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State | CO
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Zip | 81008
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Country | US
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Telephone | 719-582-1898
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Fax | 719-621-4098
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Provider Business Mailing Address
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Address Line | 1310 FORTINO BLVD STE D
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City | PUEBLO
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State | CO
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Zip | 81008-2076
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APN.0992247-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN.0205125
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APN.0992247-NP
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | APN.0992247-NP
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License Number State | CO
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