Individual
MS. BETTE T. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2500 NEFF RD., ST CHARLES MEDICAL CENTER, BEND, OR 92201-0001
(541) 706-5675
Mailing address
2500 NEFF RD., ST CHARLES MEDICAL CENTER, BEND, OR 92201-0001
(541) 706-5675
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN276756L
PA
363LN0000X
Neonatal Nurse Practitioner
RN276756L
PA
363LN0005X
Critical Care Neonatal Nurse Practitioner
200850071NP
OR
363LN0005X
Critical Care Neonatal Nurse Practitioner
RN276756L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16225
—
NJ
05
—
4033701
—
MD
Enumeration date
10/26/2006
Last updated
04/23/2020
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