Provider Demographics
NPI:1508413352
Name:SIGL, BETTYANN MARIE
Entity Type:Individual
Prefix:MRS
First Name:BETTYANN
Middle Name:MARIE
Last Name:SIGL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DOLLY
Other - Middle Name:MARIE
Other - Last Name:SIGL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4514 HOLLOWAY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33567-2061
Mailing Address - Country:US
Mailing Address - Phone:813-597-9257
Mailing Address - Fax:
Practice Address - Street 1:4514 HOLLOWAY CREEK DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33567-2061
Practice Address - Country:US
Practice Address - Phone:813-597-9257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider