Provider Demographics
NPI:1245425602
Name:NIELSEN, BETTY JEAN (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:NIELSEN
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 1:125 EAST BAILEY DR
Mailing Address - Street 2:PO BOX 187
Mailing Address - City:WHITE PLAINS
Mailing Address - State:KY
Mailing Address - Zip Code:42464
Mailing Address - Country:US
Mailing Address - Phone:270-584-6040
Mailing Address - Fax:
Practice Address - Street 1:125 EAST BAILEY DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:KY
Practice Address - Zip Code:42464
Practice Address - Country:US
Practice Address - Phone:270-584-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1086183163WM0102X
OR163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn