Physician Compare National (NPI:1780914374)

HEALTHCARE PROVIDER: KEMMARIE C BEAL APRN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1780914374
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800044793
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120919000005
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BEAL
	Individual professional last name
Provider First Name	KEMMARIE
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3580 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE G
	Group Practice or individual's line 2 address
City	HARTFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	061201121
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M