Healthcare Provider Details

I. General information

NPI: 1043364029
Provider Name (Legal Business Name): TAESEON J ADAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SPRINGS RD
BEDFORD MA
01730-1114
US

IV. Provider business mailing address

34 NEWPORT ST
ARLINGTON MA
02476-6207
US

V. Phone/Fax

Practice location:
  • Phone: 781-687-2000
  • Fax:
Mailing address:
  • Phone: 781-641-0495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number192447
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number192447
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: