Provider Demographics
NPI:1245337112
Name:BETTEZ, JANE M (APRN PCNS)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:M
Last Name:BETTEZ
Suffix:
Gender:F
Credentials:APRN PCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ERDMAN WAY
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1804
Mailing Address - Country:US
Mailing Address - Phone:978-537-0956
Mailing Address - Fax:978-537-6174
Practice Address - Street 1:100 ERDMAN WAY
Practice Address - Street 2:CHL-LIPTON CENTER
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1804
Practice Address - Country:US
Practice Address - Phone:978-537-0956
Practice Address - Fax:978-537-6174
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN182942PE163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult