=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053659417
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANN MARIE BECKWITH GIEDD MSN/FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2013
-----------------------------------------------------
Last Update Date | 03/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 413 STEWART RD
-----------------------------------------------------
City | EATON CENTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03832-0383
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-422-6231
-----------------------------------------------------
Fax | 404-422-6231
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 183
-----------------------------------------------------
City | EATON CENTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03832-0183
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-422-6231
-----------------------------------------------------
Fax | 603-367-4391
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | RN62294
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 060497-23
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------