Provider Demographics
NPI: | 1801819701 |
---|---|
Name: | BESTLAND, JENNIFER K (RN, APNP) |
Entity type: | Individual |
Prefix: | |
First Name: | JENNIFER |
Middle Name: | K |
Last Name: | BESTLAND |
Suffix: | |
Gender: | F |
Credentials: | RN, APNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1000 MINERAL POINT AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | JANESVILLE |
Mailing Address - State: | WI |
Mailing Address - Zip Code: | 53548-2940 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 608-756-6000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1000 MINERAL POINT AVE |
Practice Address - Street 2: | |
Practice Address - City: | JANESVILLE |
Practice Address - State: | WI |
Practice Address - Zip Code: | 53548-2940 |
Practice Address - Country: | US |
Practice Address - Phone: | 608-756-6000 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-25 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WI | 118848 | 363L00000X |
WI | 2562 | 363LA2100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WI | 41253000 | Medicaid | |
WI | 41253000 | Medicaid |