Provider Demographics
NPI:1215616313
Name:VARGAS-BETANCES, NAIROBY (FNP)
Entity type:Individual
Prefix:
First Name:NAIROBY
Middle Name:
Last Name:VARGAS-BETANCES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LOCUST CT
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-1811
Mailing Address - Country:US
Mailing Address - Phone:203-886-9863
Mailing Address - Fax:
Practice Address - Street 1:1080 DAY HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1781
Practice Address - Country:US
Practice Address - Phone:860-298-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily