Provider Demographics
NPI:1760281851
Name:BEAUPLAN DUVERGER, RESIDA
Entity type:Individual
Prefix:
First Name:RESIDA
Middle Name:
Last Name:BEAUPLAN DUVERGER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 RICHMOND ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1560
Mailing Address - Country:US
Mailing Address - Phone:781-492-2790
Mailing Address - Fax:
Practice Address - Street 1:335 RICHMOND ST UNIT A
Practice Address - Street 2:
Practice Address - City:EAST TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02718-1560
Practice Address - Country:US
Practice Address - Phone:781-492-2790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2392067163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse