Provider Demographics
NPI:1356890040
Name:BEENE, KRISTINA NICOLE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:NICOLE
Last Name:BEENE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:NICOLE
Other - Last Name:RAYNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:65 RACOON BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:TN
Mailing Address - Zip Code:38567
Mailing Address - Country:US
Mailing Address - Phone:615-766-2097
Mailing Address - Fax:
Practice Address - Street 1:1524 WILLIAMS DR # 102
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-3274
Practice Address - Country:US
Practice Address - Phone:615-953-9007
Practice Address - Fax:615-225-9105
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000159540163W00000X
TNAPN0000021187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse