Provider Demographics
NPI:1598842841
Name:SHIRES, BETSY WRIGHT (RN CNS NP)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:WRIGHT
Last Name:SHIRES
Suffix:
Gender:F
Credentials:RN CNS NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 W. 46TH ST.
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225
Mailing Address - Country:US
Mailing Address - Phone:804-432-8482
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1207 W. 46TH ST.
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-432-8482
Practice Address - Fax:804-828-9284
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA024181998363LP0808X
VA0015000356364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist