Kim Beaudry
Nurse Practitioner - Gerontology
55 Lake Ave N
Worcester
, Massachusetts 01655-0002
Kim Beaudry
Nurse Practitioner - Gerontology
55 Lake Ave N
Worcester
, Massachusetts 01655-0002
(413) 774-2400
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Kim Beaudry
- 329 Conway St Ste 2
- Greenfield, MA
- Zip : 01301-1522
- Phone : (413) 774-2400
Second Address
- Kim Beaudry
- 55 Lake Ave N
- Worcester, MA
- Zip : 01655-0002
- Phone : (774) 441-6605
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 156137 | MA |
National Provider Identifier
| NPI | 1083253355 |
|---|---|
| Provider Name | Kim Beaudry |
| First Address | Greenfield, MA 01301-1522 |
| Second Address | Worcester, MA 01655-0002 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/01/2020 |
| Last Update Date | 14/08/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.