NPI 1104253434 · live from the CMS NPI Registry
Gerard Robert Beaudry, MSN, ACNP
Nurse Practitioner in Lebanon, NH. National Provider Identifier 1104253434, active.
NPI record
| NPI | 1104253434 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 1 Medical Center Dr, Lebanon, NH 03756 |
| Practice phone | 603-308-1467 |
| Enumerated | October 1, 2013 |
| Last updated | August 17, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Acute Care | 363LA2100X | 063188-23 (NH) |
| Nurse Practitioner, Acute Care | 363LA2100X | 101.0118274 (VT) |
| Nurse Practitioner primary | 363L00000X | 063188-23 (NH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.