Provider Demographics
NPI:1093899221
Name:LIEBZEIT, BETTY ANN (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:LIEBZEIT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 W PINTO CIR
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-6248
Mailing Address - Country:US
Mailing Address - Phone:928-472-4559
Mailing Address - Fax:
Practice Address - Street 1:820 W PINTO CIR
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-6248
Practice Address - Country:US
Practice Address - Phone:928-472-4559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN097825163W00000X, 163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation