| Doctor Name: | TINA BEAN |
| NPI Number: | 1700993698 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 235701 |
| Business Practice Address: | 194 Tomahawk Hwy Harrells, NC - 284449765 |
| Business Phone Number: | 9105324106 |
| Business Fax Number: | |
| Mailing Address: | 194 Tomahawk Hwy, HARRELLS |
| State: | NC |
| Postal Code: | 284449765 |
| Phone Number: | 9105324106 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 06/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 235701 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |