Provider Demographics
NPI:1598046104
Name:MESSINA, BEVERLY BRAASCH (RPH)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:BRAASCH
Last Name:MESSINA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MANNING ST
Mailing Address - Street 2:
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-1932
Mailing Address - Country:US
Mailing Address - Phone:978-356-8414
Mailing Address - Fax:
Practice Address - Street 1:17 MANNING ST
Practice Address - Street 2:
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-1932
Practice Address - Country:US
Practice Address - Phone:978-356-8414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA09195183500000X
NHR1620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist