Provider Demographics
NPI:1285361774
Name:BEAN, CAITLIN ELIZABETH (NP)
Entity type:Individual
Prefix:MISS
First Name:CAITLIN
Middle Name:ELIZABETH
Last Name:BEAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 LINDEN ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4674
Mailing Address - Country:US
Mailing Address - Phone:339-788-0530
Mailing Address - Fax:
Practice Address - Street 1:12 LINDEN ST APT 4
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4674
Practice Address - Country:US
Practice Address - Phone:339-788-0530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2269753363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care