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General NPI Number Information
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NPI Number | 1457062408
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Entity Type | Individual
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Provider Name | ANNA BETH BUKVIC
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Gender | Female
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6106
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Country | US
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Telephone | 617-732-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 473 MERRIMAC ST
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City | NEWBURYPORT
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State | MA
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Zip | 01950-1847
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Country | US
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Telephone | 978-886-3153
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | RN2281916
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License Number State | MA
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