Provider Demographics
NPI:1164856456
Name:BERTELSEN, BETSY (RN)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:
Last Name:BERTELSEN
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 1:6602 S CREEKSTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-8807
Mailing Address - Country:US
Mailing Address - Phone:509-768-0363
Mailing Address - Fax:509-624-9107
Practice Address - Street 1:5504 W HALLETT RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-5625
Practice Address - Country:US
Practice Address - Phone:509-559-4241
Practice Address - Fax:509-624-9107
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00158249163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool