Provider Demographics
NPI:1346920832
Name:MENDENHALL, BETSY RENE (WHNP)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:RENE
Last Name:MENDENHALL
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9403 CROWN CREST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8991
Mailing Address - Country:US
Mailing Address - Phone:720-721-1670
Mailing Address - Fax:
Practice Address - Street 1:9403 CROWN CREST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8991
Practice Address - Country:US
Practice Address - Phone:720-721-1670
Practice Address - Fax:303-721-8117
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO197715363LX0001X
COAPN.0998994-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology