Individual
SHELLY L BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,MHA,WHNP-BC
Contact information
Practice address
639 E MAIN ST, CARSON CITY, MI 48811-9795
(989) 584-3107
(989) 584-6458
Mailing address
639 E MAIN ST, PO BOX 670, CARSON CITY, MI 48811-9795
(989) 584-3107
(989) 584-6458
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
4704173045
MI
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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