Provider Demographics
NPI:1760183669
Name:STEVENS-WINTERS, BETTY JEAN (NURSE'S AIDE -BLSCPR)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JEAN
Last Name:STEVENS-WINTERS
Suffix:
Gender:F
Credentials:NURSE'S AIDE -BLSCPR
Other - Prefix:MRS
Other - First Name:BETTY
Other - Middle Name:JEAN
Other - Last Name:STEVENS-WINTERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ASSOCIATIES PROVIDER
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691
Mailing Address - Country:US
Mailing Address - Phone:737-298-2958
Mailing Address - Fax:
Practice Address - Street 1:5817 RAVENNA LN
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-3700
Practice Address - Country:US
Practice Address - Phone:737-298-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA0000674294376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty