Individual
KARISSA TERRY BETTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
550 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7688
(678) 312-4790
Mailing address
1708 RED FOX RUN SW, LILBURN, GA 30047-2462
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
RN223218
GA
363LN0000X
Neonatal Nurse Practitioner
Primary
RN223218
GA
Other
Enumeration date
10/10/2022
Last updated
11/20/2024
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