Individual
IVY LYNN BETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
203 W PIONEER AVE, SUITE 1, HOMER, AK 99603-7527
(907) 235-0369
Mailing address
4300 BARTLETT ST, HOMER, AK 99603-7005
(907) 235-8101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26187
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMG799
—
AK
05
—
HC2563
—
AK
05
—
HH2711
—
AK
05
—
MA0272
—
AK
05
—
NA3799
—
AK
05
—
PCG519A
—
AK
Enumeration date
02/16/2010
Last updated
02/16/2010
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