Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1074 | NE |
NPI | 1003995119 |
---|---|
Provider Name | Betsy Ann Turk |
First Address | Kearney, NE 68845 |
Second Address | Kearney, NE 68847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 02/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1002505070 | (05) | NE |
U59730 | (02) |