Individual
DR. NICOLE BETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
413 W WATER STREET, GREENFIELD, MO 65661
(636) 675-5665
Mailing address
421 NW MIAMI GARDENS DR, MIAMI, FL 33169-4467
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2017042680
MO
207Q00000X
Family Medicine Physician
2017042680
MO
207R00000X
Internal Medicine Physician
Primary
2017042680
MO
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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