Provider Demographics
NPI:1063471464
Name:BETTS, ANNETTE SUE (FNP)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:SUE
Last Name:BETTS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WASHINGTON AVE N
Mailing Address - Street 2:5000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1377
Mailing Address - Country:US
Mailing Address - Phone:612-659-7111
Mailing Address - Fax:
Practice Address - Street 1:333 WASHINGTON AVE N
Practice Address - Street 2:5000
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-1377
Practice Address - Country:US
Practice Address - Phone:612-659-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1203563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500003346Medicare UPIN