MEDICARE: EMILY JOANN BEDDOES M.S.

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	231H00000X	Audiologist	2089	NC
2	237700000X	Hearing Instrument Specialist	632	NC

General Provider Information

NPI Number	:	1770973695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JOANN BEDDOES M.S.

Provider Business Mailing Address
First Line	:	6 JASMINE PL
Second Line	:
City	:	WRIGHTSVILLE BEACH
State	:	NC
Zip	:	28480-1958
Country	:	US
Telephone Number	:	910-256-4940
Fax Number	:	910-256-4940

Provider Business Practice Location Address
First Line	:	6 JASMINE PL
Second Line	:
City	:	WRIGHTSVILLE BEACH
State	:	NC
Zip	:	28480-1958
Country	:	US
Telephone Number	:	910-256-4940
Fax Number	:	910-256-4940

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

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	01/30/2015

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