Individual
JUDITH A BERUBE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
34 PARK ST, HYANNIS, MA 02601-5204
(508) 862-5650
(508) 778-4753
Mailing address
34 PARK ST, HYANNIS, MA 02601-5204
(508) 862-5650
(508) 778-4753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
179473
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP3835
BCBS PROVIDER NUMBER
MA
Enumeration date
06/24/2006
Last updated
07/08/2007
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