MEDICARE: MRS. ROSEMARY DOHERTY BYRNE NP

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	363LA2200X	Adult Health Nurse Practitioner	258563	MA
2	363LW0102X	Women's Health Nurse Practitioner	258563	MA

General Provider Information

NPI Number	:	1356405435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSEMARY DOHERTY BYRNE NP

Provider Business Mailing Address
First Line	:	19 PETER HOBART DR
Second Line	:
City	:	HINGHAM
State	:	MA
Zip	:	02043-3751
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1395 N MAIN ST
Second Line	:
City	:	RANDOLPH
State	:	MA
Zip	:	02368-1768
Country	:	US
Telephone Number	:	781-961-7887
Fax Number	:	781-986-8360

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	03/07/2023

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