Provider Demographics
NPI:1427562602
Name:BEAL, KERRY ANN ANN
Entity Type:Individual
Prefix:
First Name:KERRY ANN
Middle Name:ANN
Last Name:BEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 DUBLIN RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2501
Mailing Address - Country:US
Mailing Address - Phone:215-436-7777
Mailing Address - Fax:
Practice Address - Street 1:28 DUBLIN RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2501
Practice Address - Country:US
Practice Address - Phone:215-436-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-26
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA253776174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN