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NPI Code Detail

MEDICARE: MS. NYDIA CARMEL BEARD CNM, WHNP

MEDICARE: MS. NYDIA CARMEL BEARD CNM, WHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse Practitioner209.007423IL
2367A00000XAdvanced Practice Midwife209.007283IL

General Provider Information

NPI Number : 1922234921
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NYDIA CARMEL BEARD CNM, WHNP
Provider Business Mailing Address
First Line : 3001 BLOOMFIELD DR
Second Line :
City : JOLIET
State : IL
Zip : 60436-9700
Country : US
Telephone Number : 815-741-4396
Fax Number :
Provider Business Practice Location Address
First Line : 152 W LINCOLN HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2619
Country : US
Telephone Number : 708-754-9687
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 02/01/2011

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