Provider Demographics
NPI:1083325179
Name:BEDARD, MICHELLE M (NP)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:M
Last Name:BEDARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2504
Mailing Address - Country:US
Mailing Address - Phone:413-664-4088
Mailing Address - Fax:
Practice Address - Street 1:71 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2504
Practice Address - Country:US
Practice Address - Phone:413-664-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA193200000X363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care