Basic Information
Provider Information
NPI: 1053072629
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BESTE
FirstName: ERIN
MiddleName: ELIZABETH
NamePrefix: MS.
NameSuffix:  
Credential: APRN, CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BESTE
OtherFirstName: ERIN
OtherMiddleName: ELIZABETH
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 400 E 3RD ST
Address2:  
City: DULUTH
State: MN
PostalCode: 558051951
CountryCode: US
TelephoneNumber: 2187868364
FaxNumber:  
Practice Location
Address1: 420 E 1ST ST
Address2:  
City: DULUTH
State: MN
PostalCode: 558051901
CountryCode: US
TelephoneNumber: 2187868364
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/06/2022
LastUpdateDate: 01/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X8798MNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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