Provider Demographics
NPI:1972039642
Name:BIESCHKE, KEVYN (FNP-C, AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KEVYN
Middle Name:
Last Name:BIESCHKE
Suffix:
Gender:F
Credentials:FNP-C, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9502 OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:BEACH CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77523-9245
Mailing Address - Country:US
Mailing Address - Phone:281-543-4265
Mailing Address - Fax:
Practice Address - Street 1:4401 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2122
Practice Address - Country:US
Practice Address - Phone:281-543-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133623363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily