MEDICARE: ANNA ELIZABETH BEAN RN

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
1	363LA2100X	Acute Care Nurse Practitioner	APRN-NP268487	GA

General Provider Information

NPI Number	:	1659022077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ELIZABETH BEAN RN

Provider Business Mailing Address
First Line	:	1157 AMBERTON LN
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-6916
Country	:	US
Telephone Number	:	607-725-6519
Fax Number	:

Provider Business Practice Location Address
First Line	:	3675 J DEWEY GRAY CIR STE 300
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-1868
Country	:	US
Telephone Number	:	706-863-9595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2022
Last Update Date	:	12/08/2025

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