Individual
BERTHA ANN BETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
308 RIDGEHILL DR, HOPKINSVILLE, KY 42240-4918
(270) 348-3030
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2019340
KY
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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