Provider Demographics
NPI:1700951928
Name:BEAN, ROSEMARY WINIFRED
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:WINIFRED
Last Name:BEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROSEMARY
Other - Middle Name:WINIFRED
Other - Last Name:HILDRETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-0790
Mailing Address - Country:US
Mailing Address - Phone:541-347-8344
Mailing Address - Fax:541-347-2146
Practice Address - Street 1:89755 MEDOHILL LN
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411
Practice Address - Country:US
Practice Address - Phone:541-347-8344
Practice Address - Fax:541-347-2146
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse