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Individual
MS. KIMBERLY A BEAN
Active
Individual
MS. KIMBERLY A BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4230
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1618
—
SC
01
—
P01510934
RAILROAD MEDICARE
SC
01
—
SCB8689125
MEDICARE PTAN
—
Enumeration date
04/05/2010
Last updated
06/30/2021
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