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General NPI Number Information
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NPI Number | 1992325930
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Entity Type | Individual
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Provider Name | MARIA PAULA BETANCUR PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 19600 E 39TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2301
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Country | US
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Telephone | 913-222-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 19600 E 39TH ST S
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City | INDEPENDENCE
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State | MO
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Zip | 64057-2301
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Country | US
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Telephone | 913-222-9779
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9115193
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2023013212
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License Number State | MO
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