Bette Axiak

Individual provider Active NPI Community Health Registered Nurse · Sonora, CA

NPI 1790014801 · NPPES record last updated Dec 18, 2009

Key facts

NPI
1790014801
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
262840 (CA)
Practice address
20111 Cedar Rd N
Sonora, CA 95370-5939
Phone
(209) 533-7422
NPI assigned
Dec 18, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
262840CAMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 262840 CA Yes

Addresses

Primary practice location

20111 Cedar Rd N
Sonora, CA 95370-5939

Mailing address

20111 Cedar Rd N
Sonora, CA 95370-5939

Other providers in Sonora, CA

All providers in Sonora, CA · Community Health Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.