Individual
NICOLE BETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1310 FORTINO BLVD STE D, PUEBLO, CO 81008
(719) 582-1898
(719) 621-4098
Mailing address
1310 FORTINO BLVD STE D, PUEBLO, CO 81008-2076
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN.0205125
CO
363LA2200X
Adult Health Nurse Practitioner
APN.0992247-NP
CO
363LG0600X
Gerontology Nurse Practitioner
APN.0992247-NP
CO
363LP2300X
Primary Care Nurse Practitioner
Primary
APN.0992247-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69120251
—
CO
Enumeration date
10/02/2015
Last updated
11/30/2020
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