Provider Demographics
NPI:1508246190
Name:BEAN, JAMES (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
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 1:635 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04941-4205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:635 CENTER RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:ME
Practice Address - Zip Code:04941-4205
Practice Address - Country:US
Practice Address - Phone:207-342-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER033564163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency