Provider Demographics
NPI:1649478124
Name:WETTERS, BETTY ANN (RN)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:WETTERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:ANN RUFFINI
Other - Last Name:WETTERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3506 JOERG AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-0694
Mailing Address - Country:US
Mailing Address - Phone:209-723-5838
Mailing Address - Fax:
Practice Address - Street 1:260 E. 15TH STREET
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340
Practice Address - Country:US
Practice Address - Phone:209-381-1135
Practice Address - Fax:209-381-1215
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN359869163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator