MEDICARE: MS. BETTY M FRANZATTI

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1174721542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETTY M FRANZATTI

Provider Business Mailing Address
First Line	:	PO BOX 1179
Second Line	:
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869-1179
Country	:	US
Telephone Number	:	208-659-8543
Fax Number	:	208-623-2232

Provider Business Practice Location Address
First Line	:	33668 NEWMAN DR
Second Line	:	NOT MAILING ADDRESS PHYSICAL ADDRESS ONLY
City	:	SPIRIT LAKE
State	:	ID
Zip	:	83869-1179
Country	:	US
Telephone Number	:	208-659-8543
Fax Number	:	208-623-2232

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	07/08/2007

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