Tina Ann Betancourt
Individual provider Active NPI Family Nurse Practitioner · Mebane, NC
NPI 1578850657 · NPPES record last updated Jan 12, 2016
Key facts
- NPI
- 1578850657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5008228 (NC)
- Practice address
- 3940 Arrowhead Blvd
Mebane, NC 27302-7636 - Phone
- (919) 568-7305
- Fax
- (919) 568-7399
- NPI assigned
- Jul 8, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 711718 | TX | MD | Ambulatory Care Registered Nurse |
| 5008228 | NC | MD | Family Nurse Practitioner |
| RN711718 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Moses H. Cone Memorial Hospital Operating Corporation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 711718 | TX | |
| Family Nurse Practitioner | 363LF0000X | RN711718 | TX | |
| Registered Nurse | 163W00000X | 280748 | NC | |
| Family Nurse Practitioner | 363LF0000X | 5008228 | NC | Yes |
Addresses
Primary practice location
3940 Arrowhead Blvd
Mebane, NC 27302-7636
Mailing address
3940 Arrowhead Blvd
Mebane, NC 27302-7636
Phone (919) 568-7305
Other providers in Mebane, NC
- Behavioral Health Associates of North Carolina, Inc.
- Karen Jutta Behling
- Ana Benitez-Graham
- Kristy Lynn Berchulc
- Laura H Berglund
- Bio-Medical Applications of North Carolina Inc.
- Blakeslee Medical
- Ashley Blankenship
- Michael Blankenship
- Mike C Blankenship
All providers in Mebane, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.