Provider Demographics
NPI:1689851719
Name:ROOKS, BETTINA
Entity Type:Individual
Prefix:
First Name:BETTINA
Middle Name:
Last Name:ROOKS
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 1:633 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-1703
Mailing Address - Country:US
Mailing Address - Phone:731-986-1990
Mailing Address - Fax:
Practice Address - Street 1:633 HIGH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1703
Practice Address - Country:US
Practice Address - Phone:731-986-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide