Provider Demographics
NPI:1154445849
Name:NULL, BETSY L (NP-C)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:L
Last Name:NULL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:L
Other - Last Name:REINERT-NULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:2701 SUNSET RIDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-0007
Mailing Address - Country:US
Mailing Address - Phone:972-772-5450
Mailing Address - Fax:
Practice Address - Street 1:2701 SUNSET RIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-0007
Practice Address - Country:US
Practice Address - Phone:972-772-5450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205946101Medicaid
TXTX596539OtherTX LICENSE
TX205946102Medicaid
TX205946103Medicaid
TXTX596539OtherTX LICENSE
TXTX596539OtherTX LICENSE
TX205946101Medicaid
TX8L19345Medicare PIN