MEDICARE: MRS. SUSAN VECCHIONE DUENAS MS FNP

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	141387NP	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	NP0570	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1194791400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN VECCHIONE DUENAS MS FNP

Provider Business Mailing Address
First Line	:	714 MAIN ST
Second Line	:	SUITE 706A, BICKFORD HEALTH ASSOCIATES,PC
City	:	YARMOUTH PORT
State	:	MA
Zip	:	02675-2000
Country	:	US
Telephone Number	:	508-362-1600
Fax Number	:	508-362-1616

Provider Business Practice Location Address
First Line	:	714 MAIN ST
Second Line	:	SUITE 706A, BICKFORD HEALTH ASSOCIATES,PC
City	:	YARMOUTH PORT
State	:	MA
Zip	:	02675-2000
Country	:	US
Telephone Number	:	508-362-1600
Fax Number	:	508-362-1616

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	04/08/2008

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