Provider Demographics
NPI:1700983756
Name:BEANE, AMY T (RD, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:T
Last Name:BEANE
Suffix:
Gender:F
Credentials:RD, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SMITH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754-5765
Mailing Address - Country:US
Mailing Address - Phone:828-490-6777
Mailing Address - Fax:
Practice Address - Street 1:281 LAUREL VALLEY RD
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754-6787
Practice Address - Country:US
Practice Address - Phone:828-490-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002426133V00000X
NC234894163W00000X
NC5014153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00540OtherBC FOR SWAIN
NC00246OtherBLUE CROSS
NC560629325OtherTAX ID FOR SWAIN CO. HOSP
NC560714394OtherTAX ID FOR HARRIS REGIONA