Provider Demographics
NPI:1932343241
Name:STANLEY, BETTY (RN)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:
Other - Last Name:HOSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:736 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:736 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6015
Practice Address - Country:US
Practice Address - Phone:608-290-8030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI121242-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health