Individual
MRS. GAIL W BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
326 WASHINGTON STREET, NORWICH, CT 06360
(860) 889-8331
Mailing address
3998 FAIR RIDGE DR, SUITE # 300, FAIRFAX, VA 22033-2129
(703) 295-9360
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
000400
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004199693
—
CT
Enumeration date
06/12/2007
Last updated
03/30/2015
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