Healthcare Provider Details

I. General information

NPI: 1083325179
Provider Name (Legal Business Name): MICHELLE M BEDARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HOSPITAL AVE
NORTH ADAMS MA
01247-2504
US

IV. Provider business mailing address

71 HOSPITAL AVE
NORTH ADAMS MA
01247-2504
US

V. Phone/Fax

Practice location:
  • Phone: 413-664-4088
  • Fax:
Mailing address:
  • Phone: 413-664-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number193200000X
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: