Provider Demographics
NPI:1932655479
Name:BESAND, DANIELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BESAND
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S BOXWOOD LN
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-1626
Mailing Address - Country:US
Mailing Address - Phone:636-233-1160
Mailing Address - Fax:
Practice Address - Street 1:18 S BOXWOOD LN
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-1626
Practice Address - Country:US
Practice Address - Phone:636-233-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016030299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily