Provider Demographics
NPI:1073396420
Name:BEARD, ANA (CRNP)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3605 EDGMONT AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:19015-2862
Mailing Address - Country:US
Mailing Address - Phone:610-876-6180
Mailing Address - Fax:610-876-6130
Practice Address - Street 1:3605 EDGMONT AVE STE A
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:PA
Practice Address - Zip Code:19015-2862
Practice Address - Country:US
Practice Address - Phone:610-876-6180
Practice Address - Fax:610-876-6130
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028015363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health