Individual
ELYSSA BETTENBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 E THREE NOTCH ST STE 100, ANDALUSIA, AL 36420-3128
(334) 362-2015
Mailing address
1500 1ST AVE N UNIT 3, BIRMINGHAM, AL 35203-1866
(205) 545-5088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3-002068
AL
Other
Enumeration date
11/06/2024
Last updated
11/25/2024
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