Bernice Charlene Beddoe
Individual provider Active NPI Social Worker · Fairbanks, AK
NPI 1609901735 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609901735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 330 (AK)
- Practice address
- 620 5TH Avenue
Fairbanks, AK 99701 - Phone
- (907) 474-0890
- Fax
- (907) 474-3621
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330 | AK | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 330 | AK | Yes |
Addresses
Primary practice location
620 5TH Avenue
Fairbanks, AK 99701
Mailing address
215 Ina Street
Fairbanks, AK 99701
Phone (907) 474-0890
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.