Provider Demographics
NPI:1801102009
Name:NIX, BETTY J'NELLE (RN)
Entity type:Individual
Prefix:MS
First Name:BETTY
Middle Name:J'NELLE
Last Name:NIX
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MAJESTIC OAK CV
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-8639
Mailing Address - Country:US
Mailing Address - Phone:731-824-0339
Mailing Address - Fax:
Practice Address - Street 1:950 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-2647
Practice Address - Country:US
Practice Address - Phone:731-772-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000102304163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health