Provider Demographics
NPI:1063883932
Name:BESS, TERESA JEAN (APRN)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:JEAN
Last Name:BESS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:TERESA
Other - Middle Name:J
Other - Last Name:BACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-2203
Mailing Address - Country:US
Mailing Address - Phone:859-655-6100
Mailing Address - Fax:
Practice Address - Street 1:101 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2690
Practice Address - Country:US
Practice Address - Phone:859-881-4288
Practice Address - Fax:859-881-4388
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100381220Medicaid