Betsy Hermus

Individual provider Active NPI Registered Nurse · Little Chute, WI

NPI 1972044808 · NPPES record last updated Mar 11, 2017

Key facts

NPI
1972044808
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
102359 (WI)
Practice address
2501 W Main St
Little Chute, WI 54911-4147
Phone
(920) 716-3996
NPI assigned
Mar 11, 2017
Sex
Female
Sole proprietor
No

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
102359WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 102359 WI Yes

Addresses

Primary practice location

2501 W Main St
Little Chute, WI 54911-4147

Mailing address

2501 W Main St
Little Chute, WI 54911-4147
Phone (920) 716-3996

Other providers in Little Chute, WI

All providers in Little Chute, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.