Provider Demographics
NPI:1871235341
Name:BETTS-HOLLINS, SHIRLEY DARLENE (RN)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:DARLENE
Last Name:BETTS-HOLLINS
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 1:539 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3762
Mailing Address - Country:US
Mailing Address - Phone:740-915-7405
Mailing Address - Fax:740-915-7405
Practice Address - Street 1:539 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3762
Practice Address - Country:US
Practice Address - Phone:740-915-7405
Practice Address - Fax:740-915-7405
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN175100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse