Provider Demographics
NPI:1134963473
Name:DESIR, BEATRICE (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:
Last Name:DESIR
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MRS
Other - First Name:BEATRICE
Other - Middle Name:
Other - Last Name:DESIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:20 ARMY ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-1701
Mailing Address - Country:US
Mailing Address - Phone:781-767-8690
Mailing Address - Fax:
Practice Address - Street 1:20 ARMY ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-1701
Practice Address - Country:US
Practice Address - Phone:781-767-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2263466363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health