Provider Demographics
NPI:1790824076
Name:BEISEL, MONICA (FNP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:BEISEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 W BEAUREGARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3812
Mailing Address - Country:US
Mailing Address - Phone:325-277-4016
Mailing Address - Fax:
Practice Address - Street 1:35 E 31ST ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-2207
Practice Address - Country:US
Practice Address - Phone:325-947-5625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730404363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
151522Medicare ID - Type Unspecified
P24778Medicare UPIN
TXTXB125347Medicare PIN