Provider Demographics
NPI:1558022665
Name:DOBBS, BETTY ANN (APRN)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:DOBBS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 WEST MAIN ST
Mailing Address - Street 2:268 PENDERVILLE RD WEIR, MS 39772 (HOME ADDRESS)
Mailing Address - City:ACKERMAN
Mailing Address - State:MS
Mailing Address - Zip Code:39735
Mailing Address - Country:US
Mailing Address - Phone:662-285-3239
Mailing Address - Fax:662-285-3210
Practice Address - Street 1:1030 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39772
Practice Address - Country:US
Practice Address - Phone:662-705-3239
Practice Address - Fax:662-705-8795
Is Sole Proprietor?:No
Enumeration Date:2022-01-02
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905147363LC1500X, 363LP2300X, 363LP0808X, 363L00000X
MSR876207163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner