Provider Demographics
NPI:1205885472
Name:BIESINGER, JAMES CHRISTIAN (NP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CHRISTIAN
Last Name:BIESINGER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:J
Other - Middle Name:CHRIS
Other - Last Name:BIESINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:1055 N 500 W
Practice Address - Street 2:SUITE 100 BLDG B
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3305
Practice Address - Country:US
Practice Address - Phone:801-374-1268
Practice Address - Fax:801-812-5454
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT03399004405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT500018656OtherPALMETTO GBA
UTP32851Medicare UPIN