Provider Demographics
NPI:1649260340
Name:ESQUIBEL, BETTY ANNE (NP)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:ANNE
Last Name:ESQUIBEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 INDIANA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-3766
Mailing Address - Country:US
Mailing Address - Phone:719-561-2289
Mailing Address - Fax:719-565-1370
Practice Address - Street 1:900 INDIANA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-3766
Practice Address - Country:US
Practice Address - Phone:719-561-2289
Practice Address - Fax:719-565-1370
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49253363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner