Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | F320086-1 | NY |
NPI | 1871935593 |
---|---|
Provider Name | Betsy Rodgers |
First Address | Worcester, NY 12197-1900 |
Second Address | Worcester, NY 12197-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2013 |
Last Update Date | 27/10/2017 |