Provider Demographics
NPI:1528196243
Name:BOTELLO, NONA J (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:NONA
Middle Name:J
Last Name:BOTELLO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:NONA
Other - Middle Name:J
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 WILLIAMSBURG CIR
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-5442
Mailing Address - Country:US
Mailing Address - Phone:931-581-7751
Mailing Address - Fax:
Practice Address - Street 1:251 WILLIAMSBURG CIR
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-5442
Practice Address - Country:US
Practice Address - Phone:931-581-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000155191163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health