Provider Demographics
NPI:1124366281
Name:BETSILL, DARLENE R (CTN)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:R
Last Name:BETSILL
Suffix:
Gender:F
Credentials:CTN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 WENTWORTH WAY
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-7371
Mailing Address - Country:US
Mailing Address - Phone:770-412-0888
Mailing Address - Fax:
Practice Address - Street 1:167 WENTWORTH WAY
Practice Address - Street 2:GRIFFIN
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-7371
Practice Address - Country:US
Practice Address - Phone:770-412-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator