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NPI Code Detail

MEDICARE: NANCY JANE BEAN

MEDICARE: NANCY JANE BEAN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1215283692
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY JANE BEAN
Provider Business Mailing Address
First Line : 152 N 400 S
Second Line :
City : EPHRIAM
State : UT
Zip : 84627-5549
Country : US
Telephone Number : 435-283-8400
Fax Number : 435-283-8401
Provider Business Practice Location Address
First Line : 390 W 100 N
Second Line :
City : EPHRAIM
State : UT
Zip : 84627-2131
Country : US
Telephone Number : 435-283-4065
Fax Number : 435-283-5387
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2012
Last Update Date : 08/03/2012

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Directions to “ NANCY JANE BEAN ” Practice Location

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