Healthcare Provider Details

I. General information

NPI: 1255614541
Provider Name (Legal Business Name): NICHOLAS PAUL DENBESTEN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 10/07/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PALISADES RD
PENSACOLA FL
32504-7912
US

IV. Provider business mailing address

112 MAGNOLIA ESTATES DR
LEAGUE CITY TX
77573-4613
US

V. Phone/Fax

Practice location:
  • Phone: 888-606-0086
  • Fax: 346-223-0296
Mailing address:
  • Phone: 888-606-0086
  • Fax: 346-223-0296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6849
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY13176
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number6301014887
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: