Individual
MS. KIMBERLY A BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
122 OKATIE CENTER BLVD N STE 310, OKATIE, SC 29909-3782
(843) 706-8690
(844) 295-9802
Mailing address
955 RIBAUT RD, BEAUFORT, SC 29902-5454
(843) 522-7843
(843) 522-5945
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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