Provider Demographics
NPI:1770048886
Name:VANVIELD, BETTY (APRN)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:VANVIELD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2863 PAYNES PRAIRIE CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-6061
Mailing Address - Country:US
Mailing Address - Phone:407-301-7739
Mailing Address - Fax:
Practice Address - Street 1:400 CELEBRATION PL STE A150
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4970
Practice Address - Country:US
Practice Address - Phone:407-303-3837
Practice Address - Fax:407-303-3838
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily