Provider Demographics
NPI:1992962005
Name:EICHENAUER, BETTE JANE (RN)
Entity type:Individual
Prefix:MRS
First Name:BETTE
Middle Name:JANE
Last Name:EICHENAUER
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 1:392 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3552
Mailing Address - Country:US
Mailing Address - Phone:740-366-4851
Mailing Address - Fax:740-366-4851
Practice Address - Street 1:392 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3552
Practice Address - Country:US
Practice Address - Phone:740-366-4851
Practice Address - Fax:740-366-4851
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN227715163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse