Provider Demographics
NPI:1831601699
Name:BETSY LAYNE PRIMARY CARE, PLLC
Entity type:Organization
Organization Name:BETSY LAYNE PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-681-6859
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:BETSY LAYNE
Mailing Address - State:KY
Mailing Address - Zip Code:41605-0203
Mailing Address - Country:US
Mailing Address - Phone:606-681-6859
Mailing Address - Fax:606-202-7252
Practice Address - Street 1:387 TOWN MOUNTAIN RD STE 203
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1642
Practice Address - Country:US
Practice Address - Phone:606-899-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center