Individual
STACEY L BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1501 E 10TH ST, ATLANTIC, IA 50022-1936
(712) 243-2850
(712) 243-7423
Mailing address
1501 E 10TH ST, ATLANTIC, IA 50022-1936
(712) 243-2850
(712) 243-7423
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001688
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3032763
—
IA
Enumeration date
10/03/2006
Last updated
08/28/2019
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