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General NPI Number Information
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NPI Number | 1346980596
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Entity Type | Organization
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Legal Business Name | BEAN SHERPA LLC
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 222 S MILL AVE STE 800
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City | TEMPE
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State | AZ
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Zip | 85281-2899
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Country | US
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Telephone | 602-345-0647
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Fax | 888-518-4950
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Provider Business Mailing Address
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Address Line | 222 S MILL AVE STE 800
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City | TEMPE
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State | AZ
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Zip | 85281-2899
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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 | OWNER
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Name | THOMAS J LONGCHAMPS
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Credential |
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Telephone | 402-709-3154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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