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General NPI Number Information
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NPI Number | 1396250247
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Entity Type | Individual
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Provider Name | EMMA BECKVOLD NP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 90 BRIGHAM WAY
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City | WESTWOOD
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State | MA
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Zip | 02090-2444
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Country | US
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Telephone | 774-231-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 399 REVOLUTION DR
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City | SOMERVILLE
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State | MA
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Zip | 02145-1484
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Country | US
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Telephone | 774-231-1977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 101.0134112
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License Number State | VT
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