Provider Demographics
NPI:1407560568
Name:BEAN, ALEXANDER RAY (RN)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:RAY
Last Name:BEAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALCUTTA SQUARE MAIN BUILDING, 15655 OH-170 BLDG, CALCU
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920
Mailing Address - Country:US
Mailing Address - Phone:330-386-4303
Mailing Address - Fax:
Practice Address - Street 1:CALCUTTA SQUARE MAIN BUILDING, 15655 OH-170 BLDG, CALCU
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920
Practice Address - Country:US
Practice Address - Phone:330-386-4303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.430956163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse