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General NPI Number Information
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NPI Number | 1770043887
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Entity Type | Individual
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Provider Name | AUDRIE ANNE PESIGAN BESOYAN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 1305 BEAR MOUNTAIN BLVD
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City | ARVIN
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State | CA
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Zip | 93203-1231
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Country | US
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Telephone | 661-854-5859
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Fax | 661-854-3738
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Provider Business Mailing Address
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Address Line | 1305 BEAR MOUNTAIN BLVD
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City | ARVIN
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State | CA
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Zip | 93203-1231
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Country | US
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Telephone | 661-854-5859
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Fax | 661-854-3738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95011170
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95011170
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License Number State | CA
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