Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN2262040 | MA |
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN2262040 | MA |
NPI | 1003114794 |
---|---|
Provider Name | Erin Marie Bednarek |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01605-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2011 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110088475A | (05) | MA |