MEDICARE: TERESA MACHADO JAGODA FNP-C

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	RN275960	MA

General Provider Information

NPI Number	:	1942656111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA MACHADO JAGODA FNP-C

Provider Business Mailing Address
First Line	:	68 N FRONT ST
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-7327
Country	:	US
Telephone Number	:	508-992-1500
Fax Number	:	508-994-0745

Provider Business Practice Location Address
First Line	:	68 N FRONT ST
Second Line	:
City	:	NEW BEDFORD
State	:	MA
Zip	:	02740-7327
Country	:	US
Telephone Number	:	508-992-1500
Fax Number	:	508-994-0745

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

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	01/13/2026

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