Basic Information
Provider Information
NPI: 1982907556
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BESSENT
FirstName: ANNA
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 246 FIRST ST
Address2: SUITE 101
City: SAN FRANCISCO
State: CA
PostalCode: 941052636
CountryCode: US
TelephoneNumber: 4154952225
FaxNumber: 4154952228
Practice Location
Address1: 246 FIRST ST
Address2: SUITE 101
City: SAN FRANCISCO
State: CA
PostalCode: 941052636
CountryCode: US
TelephoneNumber: 4154952225
FaxNumber: 4154952228
Other Information
ProviderEnumerationDate: 12/21/2010
LastUpdateDate: 12/22/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X20454CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home