Provider Demographics
NPI:1437415940
Name:FOOTE, BETSEY MARIE (LVN)
Entity Type:Individual
Prefix:
First Name:BETSEY
Middle Name:MARIE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7888 FARGO PL
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-9426
Mailing Address - Country:US
Mailing Address - Phone:559-585-0801
Mailing Address - Fax:
Practice Address - Street 1:7888 FARGO PL
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-9426
Practice Address - Country:US
Practice Address - Phone:559-585-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN76908164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse