Barbara Beaudette Bock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

300-033 Issued in WI

Practice address

N3995 Annex Rd
Jefferson, WI 53549-9618

Phone

(920) 674-7105

NPI assigned

Feb 22, 2010

Last updated

Feb 22, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Barbara Ann Beaudette Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1265754907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3995 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499618",
            "telephone_number": "920-674-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3995 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499618",
            "telephone_number": "920-674-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK",
        "first_name": "BARBARA",
        "middle_name": "BEAUDETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-22",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "300-033",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "62427-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "BEAUDETTE",
            "middle_name": "ANN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Morgan Borchardt
• Colleen M Brassington, R.N.

• Family Nurse Practitioner in Jefferson, WI
• Providers in Jefferson, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.