Provider Demographics
NPI:1154145647
Name:BEAN HEALTH AND WELLNESS PLLC
Entity type:Organization
Organization Name:BEAN HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN, FPA, FNP-C
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FPA, FNP-C
Authorized Official - Phone:618-367-5553
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:PINCKNEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62274-0007
Mailing Address - Country:US
Mailing Address - Phone:618-995-8073
Mailing Address - Fax:
Practice Address - Street 1:105 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PINCKNEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62274-1458
Practice Address - Country:US
Practice Address - Phone:618-995-8073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty