MEDICARE: ERIKA BEAN FNP

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	363LF0000X	Family Nurse Practitioner	1035640	TX

General Provider Information

NPI Number	:	1982286407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA BEAN FNP

Provider Business Mailing Address
First Line	:	609 MEDICAL CENTER DR STE 2600
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-3846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 PECAN DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-5775
Country	:	US
Telephone Number	:	817-458-3254
Fax Number	:

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

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	10/11/2023

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