Shavon Bettencourt, FNP-BC
Nurse Practitioner, Family in Lowell, MA. Individual provider (NPI-1).
NPI number1710682422
StatusActive
Last updated in NPPESApr 3, 2023
Details
- NPI
- 1710682422
- Entity type
- Individual (NPI-1)
- Name
- Shavon Bettencourt
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2023
- Certification date
- Apr 3, 2023
- Last updated
- Apr 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN2300960 | MA | Yes |
| 163W00000X | Registered Nurse | RN2300960 | MA |
Other names
- Shavon Sullivan (Former Name)
Practice location
31 Parkview AveLowell, MA 01852-2919
Phone 978-967-5077
Mailing address
31 Parkview AveLowell, MA 01852-2919
Phone 978-967-5077
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