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Individual

RACHAEL MARIE BETTENCOURT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3589
(505) 823-8282
(505) 823-8275
Mailing address
PO BOX 26666, PRESBYTERIAN HEALTHCARE SERVICES - PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 9105626
FL
363AM0700X
Medical Physician Assistant
Primary
PA2011-0004
NM

Other

Enumeration date
01/11/2011
Last updated
06/08/2016
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