Provider Demographics
NPI:1265615793
Name:BRASINGTON, BETSY ROSE (LPN)
Entity type:Individual
Prefix:MS
First Name:BETSY
Middle Name:ROSE
Last Name:BRASINGTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:ROSE
Other - Last Name:CIULLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:9 SEITZ TER
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1617
Mailing Address - Country:US
Mailing Address - Phone:845-471-6714
Mailing Address - Fax:
Practice Address - Street 1:9 SEITZ TER
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1617
Practice Address - Country:US
Practice Address - Phone:845-471-6714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290649-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse