Provider Demographics
NPI:1376287326
Name:BESAKA, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:BESAKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 HAROLD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6062
Mailing Address - Country:US
Mailing Address - Phone:931-561-5945
Mailing Address - Fax:
Practice Address - Street 1:495 DUNLOP LN STE 106
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5296
Practice Address - Country:US
Practice Address - Phone:931-347-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94253164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse