Provider Demographics
NPI:1912179425
Name:ANDERSON-HULL, BETTY A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:A
Last Name:ANDERSON-HULL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 SUMAC CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45427-2835
Mailing Address - Country:US
Mailing Address - Phone:937-723-6494
Mailing Address - Fax:
Practice Address - Street 1:4602 SUMAC CT
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45427-2835
Practice Address - Country:US
Practice Address - Phone:937-723-6494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH035073164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse