Provider Demographics
NPI:1689044885
Name:KENNEL-BESSELIEU, ALLISON (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:KENNEL-BESSELIEU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 HENDERSON BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2934
Mailing Address - Country:US
Mailing Address - Phone:813-906-7707
Mailing Address - Fax:813-502-0266
Practice Address - Street 1:3314 HENDERSON BLVD STE 206
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2934
Practice Address - Country:US
Practice Address - Phone:813-906-7707
Practice Address - Fax:813-502-0266
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9284131363LP0200X
FLAPRN9284131363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015938700Medicaid
FLSKVSYOtherBLUE CROSS BLUE SHIELD
FLIJ845ZMedicare PIN