Provider Demographics
NPI:1003197799
Name:BEDARD, CHRISTINE FRANCES (RN)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:FRANCES
Last Name:BEDARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OLD POWDER HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1910
Mailing Address - Country:US
Mailing Address - Phone:508-642-9416
Mailing Address - Fax:
Practice Address - Street 1:6 OLD POWDER HOUSE RD
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1910
Practice Address - Country:US
Practice Address - Phone:508-642-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN259849163W00000X
RIRN45662163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse