Healthcare Provider Details

I. General information

NPI: 1659022077
Provider Name (Legal Business Name): ANNA ELIZABETH BEAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 J DEWEY GRAY CIR STE 300
AUGUSTA GA
30909-1868
US

IV. Provider business mailing address

1157 AMBERTON LN
POWDER SPRINGS GA
30127-6916
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-9595
  • Fax:
Mailing address:
  • Phone: 607-725-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN-NP268487
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: