MEDICARE: DONALD I. BEAUDOIN CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN144541	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

General Provider Information

NPI Number	:	1447212816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD I. BEAUDOIN CRNA

Provider Business Mailing Address
First Line	:	20 KATHY TRL
Second Line	:
City	:	UXBRIDGE
State	:	MA
Zip	:	01569
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 KATHY TRL
Second Line	:
City	:	UXBRIDGE
State	:	MA
Zip	:	01569
Country	:	US
Telephone Number	:	508-347-9016
Fax Number	:

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	08/09/2023

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