Provider Demographics
NPI:1528314226
Name:MCBEAN, QUIANNA ANGELA (LPN)
Entity type:Individual
Prefix:
First Name:QUIANNA
Middle Name:ANGELA
Last Name:MCBEAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OZONE PL
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6817
Mailing Address - Country:US
Mailing Address - Phone:347-276-9265
Mailing Address - Fax:
Practice Address - Street 1:2 OZONE PL
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6817
Practice Address - Country:US
Practice Address - Phone:347-276-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300196164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse