Provider Demographics
NPI:1720432172
Name:BESONG, CHARLES (RN, DNP, MSN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:BESONG
Suffix:
Gender:M
Credentials:RN, DNP, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 BEAVERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3064
Mailing Address - Country:US
Mailing Address - Phone:240-491-2868
Mailing Address - Fax:
Practice Address - Street 1:3341 BENNING RD NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1502
Practice Address - Country:US
Practice Address - Phone:202-543-0387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR199032363LF0000X
DCRN1025737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily