Provider Demographics
NPI:1912464017
Name:BOATENG, BETTY NYANTAKYIWAAH (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:NYANTAKYIWAAH
Last Name:BOATENG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:NYANTAKYIWAAH
Other - Last Name:AKWABOAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7313 FALLBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2105
Mailing Address - Country:US
Mailing Address - Phone:323-788-2719
Mailing Address - Fax:
Practice Address - Street 1:7313 FALLBROOK AVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2105
Practice Address - Country:US
Practice Address - Phone:323-788-2719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA704253163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care