Provider Demographics
NPI:1639107592
Name:BATEJAN, BETSY (CNM)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:BATEJAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W GERMANTOWN PIKE
Mailing Address - Street 2:STE 220
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-4261
Mailing Address - Country:US
Mailing Address - Phone:484-622-7940
Mailing Address - Fax:
Practice Address - Street 1:1427 VINE ST
Practice Address - Street 2:7TH FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1031
Practice Address - Country:US
Practice Address - Phone:215-762-7824
Practice Address - Fax:215-246-5257
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW008584L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2080863OtherPRUDENTIAL
PA2543297OtherAETNA PROFESSIONAL
PA7272228OtherUSHC PROFESSIONAL
PA929580OtherKEYSTONE PROFESSIONAL
PA929580OtherPERSONAL CHOICE PROF
PAP003418OtherCHAMPUS
PA868291000OtherBLUECROSS - HMO
PA929580OtherBLUE CROSS PPO
PA291259OtherMAMSI
PA01835541-01OtherAMERICHOICE - MA
PA1835541Medicaid
PA8463441OtherCIGNA
PA929580OtherBLUE SHIELD PROFESSIONAL