Provider Demographics
NPI:1669489498
Name:BESTE, JEFFREY L (PA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:BESTE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18011 OAK ST
Mailing Address - Street 2:A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-6057
Mailing Address - Country:US
Mailing Address - Phone:402-980-5708
Mailing Address - Fax:
Practice Address - Street 1:18011 OAK ST
Practice Address - Street 2:A
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-6057
Practice Address - Country:US
Practice Address - Phone:402-980-5708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE504363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38930OtherBLUE CROSS BLUE SHIELD
NEP00334402OtherMEDICARE RAILROAD (D4S)
NE263544OtherMIDLANDS CHOICE
NE39022OtherBLUE CROSS BLUE SHIELD
NE263544OtherMIDLANDS CHOICE
NEP00334402OtherMEDICARE RAILROAD (D4S)