Provider Demographics
NPI:1245559806
Name:BESANCON, KIMBERLY RAE (RNFA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RAE
Last Name:BESANCON
Suffix:
Gender:F
Credentials:RNFA
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Mailing Address - Street 1:515 W MAYFIELD RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2083
Mailing Address - Country:US
Mailing Address - Phone:817-467-3000
Mailing Address - Fax:817-467-3001
Practice Address - Street 1:515 W MAYFIELD RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2083
Practice Address - Country:US
Practice Address - Phone:817-467-3000
Practice Address - Fax:817-467-3001
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX640482364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical