Provider Demographics
NPI:1134793144
Name:BETTS, SHARON ANN (RN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:BETTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:70 WATERBURY RD UNIT 7237
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-7710
Mailing Address - Country:US
Mailing Address - Phone:203-910-8225
Mailing Address - Fax:203-758-3754
Practice Address - Street 1:29 SMOKE RISE CIR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1047
Practice Address - Country:US
Practice Address - Phone:203-910-8225
Practice Address - Fax:203-758-3754
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE53296163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty