Provider Demographics
NPI:1821390915
Name:BESS, CHARLOTTE DENISE (RN, MSN, FNP)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:DENISE
Last Name:BESS
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:
Other - First Name:CHARLOTTE
Other - Middle Name:DENISE
Other - Last Name:LAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP
Mailing Address - Street 1:RURAL ROUTE 2 BOX 223
Mailing Address - Street 2:PO BOX 4
Mailing Address - City:PATTON
Mailing Address - State:MO
Mailing Address - Zip Code:63662
Mailing Address - Country:US
Mailing Address - Phone:573-315-1844
Mailing Address - Fax:
Practice Address - Street 1:8300 EAGER RD STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1421
Practice Address - Country:US
Practice Address - Phone:314-362-1777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007007057163WC0200X, 163W00000X
ARR78413163WE0003X, 163WG0000X, 163WH1000X, 163WP0809X, 163WX0800X
MO2018038757363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily