Provider Demographics
NPI:1346627296
Name:ALEVRAS, BETTY (APRN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:ALEVRAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-7012
Mailing Address - Country:US
Mailing Address - Phone:606-594-1769
Mailing Address - Fax:606-596-0473
Practice Address - Street 1:21 CRESTVIEW DRIVE
Practice Address - Street 2:204 TOWN BRANCH ROAD
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962
Practice Address - Country:US
Practice Address - Phone:606-594-1769
Practice Address - Fax:606-596-0473
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily