Provider Demographics
NPI:1285375360
Name:BEAN, ALEXIS KATHRYN (MD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KATHRYN
Last Name:BEAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S NATIONAL AVE STE 700
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5279
Mailing Address - Country:US
Mailing Address - Phone:417-269-8817
Mailing Address - Fax:
Practice Address - Street 1:3800 S NATIONAL AVE STE 700
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5279
Practice Address - Country:US
Practice Address - Phone:417-269-8817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program