KIMBERLY L BEAULIEU (NPI# 1467448878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467448878 |
| Entity Type | Individual |
| Full Name | KIMBERLY L BEAULIEU |
| Credential | PA-C |
| Practice Address |
675 Tower Ave Hartford CT 06112-1264 |
| Mailing Address |
520 Hartford Tpke Ste M Vernon Rockville CT 06066-5044 |
| Practice Telephone | 8607142913 |
| Practice Fax Number | 8607148988 |
| Mailing Telephone | 8608718321 |
| Mailing Fax Number | 8608756271 |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 000195 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730416793 | Kimberly G Beaulieu | Registered Nurse | 123 Medical Center Dr, Lactation Services, Brunswick, ME 04011-2652 | 2009-11-12 |
| 1669706859 | Kimberly Beaulieu | Counselor | 800 Cummings Ctr, Suite 266t, Beverly, MA 01915-6175 | 2009-09-22 |
| Street Address |
675 TOWER AVE |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053833475 | Mona Anne Chiurillo | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2017-07-07 |
| 1457758179 | Shivanna Subramani Gonzalez | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2014-11-24 |
| 1750626032 | Melissa Leigh Costanzo | Marriage & Family Therapist | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2012-11-28 |
| 1477846319 | Susana L Mealha | Social Worker | 675 Tower Ave, Suite 303, Hartford, CT 06112-1273 | 2011-05-25 |
| 1396038691 | Javeeria Manzoor | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-05-18 |
| 1912204504 | Elaine F Pratt | Nurse Practitioner | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-02-17 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1144522160 | Community Renewal Team Inc. | Case Management | 675 Tower Ave, Hartford, CT 06451 | 2010-11-23 |
| 1154638815 | Mahreen Raza | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2010-09-01 |
| 1568775419 | Stacey Lynn Johnson | Social Worker | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2010-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265961775 | Jessica Cerrato | Physician Assistant | Hartford Hospital Emergency Dept, 80 Seymour Street, Hartford, CT 06102-5037 | 2017-06-08 |
| 1528471687 | Ephraim Wakszul | Physician Assistant | 19 Woodland St Ste 23, Hartford, CT 06105-2368 | 2014-06-06 |
| 1912321183 | Lauren Schmidtberg | Physician Assistant | 282 Washington St # 2l, Hartford, CT 06106-3322 | 2014-02-09 |
| 1710093869 | Tara Breslin | Physician Assistant | 490 Blue Hills Avenue, Mt.sinai Rehabilitation Hospital/ Physician Suite, Hartford, CT 06112-3088 | 2006-08-22 |
| 1760490676 | Jean Anne Mccracken Turcotte | Physician Assistant | 100 Retreat Ave Ste 811, Hartford, CT 06106-2528 | 2006-08-04 |
| 1700809795 | Sanford Clinic | Physician Assistant | 905 N Oaks Ave, Hartford, SD 57033-6358 | 2006-07-25 |
| 1255394904 | Johanna B Cahill | Physician Assistant | 85 Seymour St Ste 719, Hartford, CT 06106-5560 | 2006-04-11 |
| 1730168634 | Tina Robbins | Physician Assistant | 401 New Britain Ave, Hartford, CT 06106 | 2006-01-10 |
| 1225029663 | Christopher J Delgross | Physician Assistant | 114 Woodland Street, Department of Medicine, Hartford, CT 06105 | 2005-11-03 |
| 1568451698 | Shawn Christine Hake | Physician Assistant | 402 W Sumner St, Hartford, WI 53027-1400 | 2005-10-20 |
| Find all providers in HARTFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.