Provider Demographics
NPI:1346587292
Name:BEAN, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:BEAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 US HIGHWAY 441 S
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-6247
Mailing Address - Country:US
Mailing Address - Phone:863-763-0428
Mailing Address - Fax:863-215-7921
Practice Address - Street 1:3551 US HIGHWAY 441 S
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974-6247
Practice Address - Country:US
Practice Address - Phone:863-763-0428
Practice Address - Fax:863-215-7921
Is Sole Proprietor?:No
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 36753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist