Provider Demographics
NPI:1770012015
Name:COLQUITT, BETSY JANICE (FNP-C)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:JANICE
Last Name:COLQUITT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:BETSY
Other - Middle Name:JANICE
Other - Last Name:COLQUITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BETSY COLQUITT FNP-C
Mailing Address - Street 1:279 NAPIER RD
Mailing Address - Street 2:
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-6832
Mailing Address - Country:US
Mailing Address - Phone:478-968-7776
Mailing Address - Fax:
Practice Address - Street 1:675 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:GA
Practice Address - Zip Code:31087-1837
Practice Address - Country:US
Practice Address - Phone:706-444-5242
Practice Address - Fax:706-444-7302
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN084987363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN084987OtherFNP-C