Provider Demographics
NPI:1518152727
Name:BIESTERVELD, ANITA M (APNP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:BIESTERVELD
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42320 HIGHWAY 195
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-7064
Mailing Address - Country:US
Mailing Address - Phone:205-486-8898
Mailing Address - Fax:205-486-8908
Practice Address - Street 1:26279 HIGHWAY 195
Practice Address - Street 2:
Practice Address - City:DOUBLE SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:35553-2554
Practice Address - Country:US
Practice Address - Phone:205-489-3322
Practice Address - Fax:205-489-3325
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3211363L00000X
AL1-192892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner