Provider Demographics
NPI:1700242500
Name:BETCHER, BRITTNEY (RN)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:BETCHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:125 FALCON XING
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-4280
Mailing Address - Country:US
Mailing Address - Phone:612-240-7528
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-1972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 206225-3163W00000X
MN46901915163WM0705X
MN940800163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WS0200XNursing Service ProvidersRegistered NurseSchool