Individual
BETTYANN CARLIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 NEWHALL ST, PHILADELPHIA, PA 19144-4227
(267) 290-8543
Mailing address
4615 NEWHALL ST, PHILADELPHIA, PA 19144-4227
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN269771
PA
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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