Provider Demographics
NPI:1992761142
Name:BETEET, MICHAEL T (ARNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:BETEET
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8686 W 96TH ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212
Mailing Address - Country:US
Mailing Address - Phone:913-648-8880
Mailing Address - Fax:913-648-8881
Practice Address - Street 1:8686 W 96TH ST
Practice Address - Street 2:SUITE 112
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212
Practice Address - Country:US
Practice Address - Phone:913-648-8880
Practice Address - Fax:913-648-8881
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P30511Medicare UPIN