Provider Demographics
NPI:1679744866
Name:ANDREWS-HALL, BETTY LEE
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:LEE
Last Name:ANDREWS-HALL
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 1:128 SAINT NICHOLAS CIR
Mailing Address - Street 2:
Mailing Address - City:CANKTON
Mailing Address - State:LA
Mailing Address - Zip Code:70584-5936
Mailing Address - Country:US
Mailing Address - Phone:337-668-4140
Mailing Address - Fax:
Practice Address - Street 1:128 SAINT NICHOLAS CIR
Practice Address - Street 2:
Practice Address - City:CANKTON
Practice Address - State:LA
Practice Address - Zip Code:70584-5936
Practice Address - Country:US
Practice Address - Phone:337-668-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver