Miranda Beaudoin
Pharmacist in Portland, ME. Individual provider (NPI-1).
NPI number1255612644
StatusActive
Last updated in NPPESAug 30, 2011
Details
- NPI
- 1255612644
- Entity type
- Individual (NPI-1)
- Name
- Miranda Beaudoin
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 30, 2011
- Last updated
- Aug 30, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | pr5642 | ME | Yes |
Practice location
340 Allen AvePortland, ME 04103-3804
Phone 207-878-0530 · Fax 207-878-0546
Mailing address
539 Auburn StPortland, ME 04103-6006
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