Healthcare Provider Details

I. General information

NPI: 1376338046
Provider Name (Legal Business Name): ALBERT LOVONE BEARD JR. FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 RADFORD BLVD
DILLON SC
29536-5001
US

IV. Provider business mailing address

604 E CRICKLEWOOD DR
FLORENCE SC
29505-5105
US

V. Phone/Fax

Practice location:
  • Phone: 843-605-0270
  • Fax:
Mailing address:
  • Phone: 843-409-0375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28698
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: