Betancourt, Diana Jazmin

Betancourt, Diana Jazmin is an individual health care provider with primary practice located at 4100 S 4Th St , Leavenworth KS 66048-5082. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Betancourt, Diana Jazmin can be contacted via phone (913) 758-6188.

Contact Information

Primary practice address
4100 S 4Th St Leavenworth KS 66048-5082
Phone: (913) 758-6188
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 000000000000 Kansas

Profile Details

NPI number 1669188165
LBN Legal business name Betancourt, Diana Jazmin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2023
Last updated Jan 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669188165 NPPES
Kansas MEDICAID 000000000000000000

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