Individual
MADELINE JOSEPHINE BETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 895-8670
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 985-1423
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9479530
FL
363L00000X
Nurse Practitioner
Primary
6761972
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114079955
RN
ID
Enumeration date
05/14/2024
Last updated
10/15/2024
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