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NPI Code Detail

MEDICARE: KATHERINE BESOLA APRN, FNP-BC

MEDICARE: KATHERINE BESOLA APRN, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPN0000021799TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1APN21799OTHERTNLICENSE

General Provider Information

NPI Number : 1134663628
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BESOLA APRN, FNP-BC
Provider Business Mailing Address
First Line : 6350 W ANDREW JOHNSON HWY
Second Line : DEPARTMENT 100
City : TALBOTT
State : TN
Zip : 37877-8605
Country : US
Telephone Number : 800-355-3565
Fax Number : 423-714-2355
Provider Business Practice Location Address
First Line : 1004 N HIGHWAY 92 STE B
Second Line :
City : JEFFERSON CITY
State : TN
Zip : 37760-3687
Country : US
Telephone Number : 865-647-3400
Fax Number : 865-647-3401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2016
Last Update Date : 12/06/2022

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