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Individual

ELLOIS ESTHER BETTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1814 LASALLE ST, RACINE, WI 53402-4630
(262) 633-2262
Mailing address
1814 LASALLE ST, RACINE, WI 53402-4630

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
78340-030
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39916500
WI
Enumeration date
07/04/2006
Last updated
07/09/2007
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