Individual
CAROLYN BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1786 BEAVER TRAIL DR, CORDOVA, TN 38016
(901) 315-1084
(901) 249-7686
Mailing address
1786 BEAVER TRAIL DR, CORDOVA, TN 38016-6037
(901) 315-1084
(901) 249-7686
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000000023292
STATE LICENSE
TN
Enumeration date
06/22/2018
Last updated
12/03/2018
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