Provider Demographics
NPI:1215486972
Name:BATTAGLIA, BETTY J (CRNP, OTR)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:J
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:CRNP, OTR
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:
Other - Last Name:HUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:90 CLEAR CREEK GLN
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6764
Mailing Address - Country:US
Mailing Address - Phone:443-350-2189
Mailing Address - Fax:410-392-8092
Practice Address - Street 1:90 CLEAR CREEK GLN
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6764
Practice Address - Country:US
Practice Address - Phone:443-350-2189
Practice Address - Fax:410-392-8092
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04562225XG0600X
MDR192725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology