MEDICARE: DAISY CUETO BETANCOURT RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	841140	TX

General Provider Information

NPI Number	:	1073456000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY CUETO BETANCOURT RN

Provider Business Mailing Address
First Line	:	2632 FRANCISCAN DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-4642
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-7345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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