Provider Demographics
NPI:1316724586
Name:CHEPKWONY, BETSY CHEBET (RN)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:CHEBET
Last Name:CHEPKWONY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 120TH LN NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-1675
Mailing Address - Country:US
Mailing Address - Phone:763-313-5953
Mailing Address - Fax:
Practice Address - Street 1:3828 120TH LN NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-1675
Practice Address - Country:US
Practice Address - Phone:763-313-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNT570256765412343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)