Provider Demographics
NPI:1982282786
Name:BESHEARS, RENAE (APRN)
Entity Type:Individual
Prefix:
First Name:RENAE
Middle Name:
Last Name:BESHEARS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RENAE
Other - Middle Name:
Other - Last Name:MEITLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3115 NUTMEG LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-3226
Mailing Address - Country:US
Mailing Address - Phone:620-200-7144
Mailing Address - Fax:
Practice Address - Street 1:1600 E 1ST ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2070
Practice Address - Country:US
Practice Address - Phone:620-770-4117
Practice Address - Fax:620-770-4120
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-79647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner