Provider Demographics
NPI:1699853705
Name:BESTE, NANCY SMITH (PA-C REGPSYCHOTHER)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SMITH
Last Name:BESTE
Suffix:
Gender:F
Credentials:PA-C REGPSYCHOTHER
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:393 S. HARLAN SUITE 105
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226
Mailing Address - Country:US
Mailing Address - Phone:303-596-7122
Mailing Address - Fax:206-350-8698
Practice Address - Street 1:393 S. HARLAN SUITE 105
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226
Practice Address - Country:US
Practice Address - Phone:303-596-7122
Practice Address - Fax:206-350-8698
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0107312101YA0400X, 103TC1900X, 103TP2701X
CO1354363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO16837860Medicaid
CO16837860Medicaid