Individual
KELLEY LYNN BEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4459
(614) 722-4458
Mailing address
561 DOWLING ST, ASHVILLE, OH 43103-2504
(740) 983-1066
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
COA.07909
OH
363LP2300X
Primary Care Nurse Practitioner
COA.07909
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2693189
—
OH
Enumeration date
06/30/2006
Last updated
02/23/2022
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