Individual
DR. BETTY JEAN KETCHMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD RP
Contact information
Practice address
8637 S 99 CIRCLE, LAVISTA, NE 68128-7010
(402) 639-0965
Mailing address
8637 S 99 CIRCLE, LAVISTA, NE 68128-7010
(402) 639-0965
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10348
NE
183500000X
Pharmacist
P7739
ID
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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