Provider Demographics
NPI:1134663628
Name:BESOLA, KATHERINE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BESOLA
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LINDSAY
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6350 W ANDREW JOHNSON HWY
Mailing Address - Street 2:DEPARTMENT 100
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8605
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:1004 N HIGHWAY 92 STE B
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-3687
Practice Address - Country:US
Practice Address - Phone:865-647-3400
Practice Address - Fax:865-647-3401
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000021799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN21799OtherLICENSE