Provider Demographics
NPI:1285870527
Name:HUSKEY, BETTY L
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:L
Last Name:HUSKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3223
Mailing Address - Street 2:MONTGOMERY AREA MENTAL HEALTH AUTHORITY
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109
Mailing Address - Country:US
Mailing Address - Phone:334-279-7830
Mailing Address - Fax:334-277-8862
Practice Address - Street 1:2140 UPPER WETUMPKA RD
Practice Address - Street 2:MONTGOMERY MENTAL HEALTH AUTHORITY
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36107-1342
Practice Address - Country:US
Practice Address - Phone:706-295-6285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-128928363L00000X
GARN044704363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health