Provider Demographics
NPI:1225539877
Name:BESSMERTNY, DENIS (NP)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:BESSMERTNY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 W RED ROCK RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8120
Mailing Address - Country:US
Mailing Address - Phone:480-747-1312
Mailing Address - Fax:
Practice Address - Street 1:5552 W RED ROCK RIDGE ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-8120
Practice Address - Country:US
Practice Address - Phone:480-747-1312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily