Provider Demographics
NPI:1922122563
Name:VARNUM, BETTY B (CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:B
Last Name:VARNUM
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 STONEMARK DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6685
Mailing Address - Country:US
Mailing Address - Phone:702-492-7227
Mailing Address - Fax:
Practice Address - Street 1:61 STONEMARK DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-6685
Practice Address - Country:US
Practice Address - Phone:702-492-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN48794163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant