MEDICARE: MRS. KRISTINA NICOLE BEENE FNP-C

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
1	163W00000X	Registered Nurse	RN0000159540	TN
2	363LF0000X	Family Nurse Practitioner	APN0000021187	TN

General Provider Information

NPI Number	:	1356890040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTINA NICOLE BEENE FNP-C

Provider Business Mailing Address
First Line	:	65 RACOON BRANCH LN
Second Line	:
City	:	HICKMAN
State	:	TN
Zip	:	38567
Country	:	US
Telephone Number	:	615-766-2097
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 WILLIAMS DR # 102
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-3274
Country	:	US
Telephone Number	:	615-953-9007
Fax Number	:	615-225-9105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2016
Last Update Date	:	07/03/2024

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