Provider Demographics
NPI:1811695380
Name:BETTS-HUDSON, JENNIFER (EMTB)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BETTS-HUDSON
Suffix:
Gender:F
Credentials:EMTB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 US HIGHWAY 6 STE 124
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-5057
Mailing Address - Country:US
Mailing Address - Phone:219-614-4186
Mailing Address - Fax:219-734-6533
Practice Address - Street 1:2134 LANDMARK ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-2570
Practice Address - Country:US
Practice Address - Phone:219-614-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-23
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker