Provider Demographics
NPI:1679740120
Name:KYSER, BETTY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:ANN
Last Name:KYSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3054 GREENHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042
Mailing Address - Country:US
Mailing Address - Phone:410-465-1585
Mailing Address - Fax:
Practice Address - Street 1:3054 GREENHAVEN CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7828
Practice Address - Country:US
Practice Address - Phone:410-465-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040080208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics