Provider Demographics
NPI:1518551845
Name:BETTEN, JOSEPH KENT (RN)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KENT
Last Name:BETTEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 JAMES K BLVD
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1815
Mailing Address - Country:US
Mailing Address - Phone:248-421-3504
Mailing Address - Fax:
Practice Address - Street 1:920 JAMES K BLVD
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1815
Practice Address - Country:US
Practice Address - Phone:248-421-3504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704156684163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health