Provider Demographics
NPI:1790582880
Name:BETZ-MARQUEZ, LISA (PROVIDER)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BETZ-MARQUEZ
Suffix:
Gender:
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140170 COUNTY ROAD 20
Mailing Address - Street 2:
Mailing Address - City:GERING
Mailing Address - State:NE
Mailing Address - Zip Code:69341-7210
Mailing Address - Country:US
Mailing Address - Phone:308-672-1114
Mailing Address - Fax:
Practice Address - Street 1:140170 COUNTY ROAD 20
Practice Address - Street 2:
Practice Address - City:GERING
Practice Address - State:NE
Practice Address - Zip Code:69341-7210
Practice Address - Country:US
Practice Address - Phone:308-672-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion