MEDICARE: BEATRICE KAMYA RNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	250471	MA

General Provider Information

NPI Number	:	1124683545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE KAMYA RNP

Provider Business Mailing Address
First Line	:	4206 STEARNS HILL RD
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-7122
Country	:	US
Telephone Number	:	781-354-9102
Fax Number	:

Provider Business Practice Location Address
First Line	:	4206 STEARNS HILL RD
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-7122
Country	:	US
Telephone Number	:	781-354-9102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2019
Last Update Date	:	05/02/2019

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