Healthcare Provider Details

I. General information

NPI: 1609613611
Provider Name (Legal Business Name): KIMBERLY BEEBE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 WARD HILL AVE
BRADFORD MA
01835-5896
US

IV. Provider business mailing address

145 WARD HILL AVE
BRADFORD MA
01835-6928
US

V. Phone/Fax

Practice location:
  • Phone: 978-372-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN2355337
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: