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NPI Code Detail

MEDICARE: DEANA BEARD APRN

MEDICARE: DEANA BEARD APRN
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
1363L00000XNurse Practitioner11020138FL
2363LF0000XFamily Nurse Practitioner1-185776AL

General Provider Information

NPI Number : 1376630491
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANA BEARD APRN
Provider Business Mailing Address
First Line : 350 GRAND AVE
Second Line :
City : FAIRHOPE
State : AL
Zip : 36532-2628
Country : US
Telephone Number : 615-305-7269
Fax Number :
Provider Business Practice Location Address
First Line : 500 SPANISH FORT BLVD
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5018
Country : US
Telephone Number : 251-626-4132
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2006
Last Update Date : 11/09/2023

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