Doctor Name: | MRS. JEANNE BEDARD |
NPI Number: | 1083687057 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 001409 |
Business Practice Address: | 346 Pomfret St Putnam, CT - 062601871 |
Business Phone Number: | 8609280815 |
Business Fax Number: | 8609284514 |
Mailing Address: | Po Box 591, PUTNAM |
State: | CT |
Postal Code: | 062600591 |
Phone Number: | 8609280815 |
Fax Number: | 8609284514 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | 001409 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |