MEDICARE: MRS. SUSAN SCOTT BEAN R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	RN033875	LA

General Provider Information

NPI Number	:	1427102037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN SCOTT BEAN R.N.

Provider Business Mailing Address
First Line	:	703 MOUND ST
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-3021
Country	:	US
Telephone Number	:	318-339-7076
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 FOURTH ST
Second Line	:	SUITE 2
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2004
Country	:	US
Telephone Number	:	318-339-8553
Fax Number	:	318-339-8554

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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