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General NPI Number Information
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NPI Number | 1245800093
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Entity Type | Individual
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Provider Name | BRIGID BEAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 3010 FOREST VIEW RD
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City | ROCKFORD
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State | IL
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Zip | 61109-1640
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Country | US
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Telephone | 877-726-6494
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Fax |
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Provider Business Mailing Address
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Address Line | 3149 DANBURY DR W
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City | JANESVILLE
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State | WI
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Zip | 53546-8825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209020087
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License Number State | IL
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