Provider Demographics
NPI:1205512837
Name:PARENT-CAZEAU, BETINA CLARSKY (MSN, APRN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:BETINA
Middle Name:CLARSKY
Last Name:PARENT-CAZEAU
Suffix:
Gender:F
Credentials:MSN, APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:BETINA
Other - Middle Name:CLARSKY
Other - Last Name:PARENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, AGPCNP-BC
Mailing Address - Street 1:1501 EDGEMORE AVE SUITE B
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:646-334-2166
Mailing Address - Fax:
Practice Address - Street 1:1501 EDGEMORE AVE SUITE B
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:646-334-2166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026413363LA2200X
MDR241783363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health