Provider Demographics
NPI:1730375429
Name:LAY, BETTY JUNE
Entity type:Individual
Prefix:MS
First Name:BETTY
Middle Name:JUNE
Last Name:LAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 COCHISE RD
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72529-1823
Mailing Address - Country:US
Mailing Address - Phone:870-257-3753
Mailing Address - Fax:
Practice Address - Street 1:40 COCHISE RD
Practice Address - Street 2:
Practice Address - City:CHEROKEE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:72529-1823
Practice Address - Country:US
Practice Address - Phone:870-257-3753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR141900783372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141900783OtherCAREGIVER,PROVIDER NUMBER