Provider Demographics
NPI:1639831407
Name:BEARD, JANEEN (FNP)
Entity type:Individual
Prefix:MRS
First Name:JANEEN
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 STANTON HILL RD
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:PA
Mailing Address - Zip Code:16345-3319
Mailing Address - Country:US
Mailing Address - Phone:330-651-5700
Mailing Address - Fax:
Practice Address - Street 1:5607 ROUTE 957
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:PA
Practice Address - Zip Code:16345-2033
Practice Address - Country:US
Practice Address - Phone:814-883-8729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF09211403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily