Provider Demographics
NPI:1538609581
Name:BESHEARS, CARRI (BSN, RN)
Entity type:Individual
Prefix:
First Name:CARRI
Middle Name:
Last Name:BESHEARS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 178TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-4629
Mailing Address - Country:US
Mailing Address - Phone:253-325-2481
Mailing Address - Fax:
Practice Address - Street 1:2516 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-5102
Practice Address - Country:US
Practice Address - Phone:360-710-5754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60673704163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control