Individual provider · Type 1 NPI
Betsy Custard
Lodging Provider · Prescott Valley, AZ
NPI number
1164666236
Active
Practice location
3484 N Constance Dr.
Prescott Valley, AZ 86314
Mailing address
440 N Washington Ave
Prescott, AZ 86301-2642
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Lodging Provider Primary | 177F00000X | 12586 (AZ) |
Lodging Provider: A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
About NPI 1164666236
Betsy Custard's National Provider Identifier is 1164666236, issued on Apr 21, 2009. The primary taxonomy on file is Lodging Provider (177F00000X), and the practice location is in Prescott Valley, AZ. The record was last updated on Apr 21, 2009.