Provider Demographics
NPI:1639824212
Name:HOCKEY, BETTY
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:HOCKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3875 SAN PABLO RD S APT 203
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-6805
Mailing Address - Country:US
Mailing Address - Phone:904-418-1603
Mailing Address - Fax:
Practice Address - Street 1:3875 SAN PABLO RD S APT 203
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-6805
Practice Address - Country:US
Practice Address - Phone:904-418-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-13
Last Update Date:2022-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide