Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN2296501 | MA |
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN2296501 | MA |
NPI | 1114565181 |
---|---|
Provider Name | Christina M Betances |
First Address | West Bridgewater, MA 02379-1056 |
Second Address | Bradford, MA 01835-5896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2019 |
Last Update Date | 05/03/2020 |