Provider Demographics
NPI:1477195238
Name:BESTEN, CASSILLY BALLARD (APRN)
Entity Type:Individual
Prefix:MS
First Name:CASSILLY
Middle Name:BALLARD
Last Name:BESTEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:CASSIE
Other - Middle Name:BALLARD
Other - Last Name:BESTEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 910082
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-0082
Mailing Address - Country:US
Mailing Address - Phone:859-260-6460
Mailing Address - Fax:859-278-0260
Practice Address - Street 1:1700 NICHOLASVILLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1463
Practice Address - Country:US
Practice Address - Phone:859-260-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013767363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3013767OtherKY BOARD OF NURSING APRN LICENSE
KYF08190602OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS (AANP) CERTIFICATION BOARD