Provider Demographics
NPI:1952325003
Name:ROSE, BETSY NORTON
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:NORTON
Last Name:ROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:A
Other - Last Name:NORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:329 CUMMINGS ST
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-3207
Mailing Address - Country:US
Mailing Address - Phone:276-628-9970
Mailing Address - Fax:276-628-9937
Practice Address - Street 1:329 CUMMINGS ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-3207
Practice Address - Country:US
Practice Address - Phone:276-628-9970
Practice Address - Fax:276-628-9937
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001369156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician