Provider Demographics
NPI:1740902766
Name:BETT, VINCENT (PMHNP)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:BETT
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 ALICE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6501
Mailing Address - Country:US
Mailing Address - Phone:505-347-8507
Mailing Address - Fax:517-224-5808
Practice Address - Street 1:5909 ALICE AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6501
Practice Address - Country:US
Practice Address - Phone:505-347-8507
Practice Address - Fax:517-224-5808
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ288707251S00000X
NM51721363L00000X
NM54721363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty