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NPI Code Detail

MEDICARE: BETTY SHABY NP

MEDICARE: BETTY SHABY NP
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
1363LA2200XAdult Health Nurse PractitionerRN480762CA

General Provider Information

NPI Number : 1689711137
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTY SHABY NP
Provider Business Mailing Address
First Line : 6801 COLDWATER CANYON AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-5162
Country : US
Telephone Number : 818-763-1718
Fax Number :
Provider Business Practice Location Address
First Line : 6801 COLDWATER CANYON AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91605-5162
Country : US
Telephone Number : 818-763-1718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 12/01/2021

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