Individual ProviderKelly BetzNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address8033 Dixie Hwy, Louisville, KY 40258-1344(502) 899-6150(502) 588-4710PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Betz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1245751056Provider TypeIndividualFull NameBetz, KellyCredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date6/30/2017Last Updated10/12/2020Contact InformationPractice LocationPractice Address8033 Dixie Hwy, Louisville, KY 40258-1344Phone(502) 899-6150Fax(502) 891-6368Mailing LocationMailing AddressPO Box 909, Louisville, KY 40201-0909Phone(502) 588-4710Fax(502) 588-4771Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense3011450KentuckyProvider IdentifiersIDDescriptionIssuerIDF06172199DescriptionOtherIssuerAANP CERTIFICATION NUMBER