NPI Profile for RIVERS EDGE PRIMARY CARE LLC in CHICOPEE, MA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Adult Health |
363LA2200X | 50 | Nurse Practitioner | |
Community Health |
363LC1500X | 50 | Nurse Practitioner | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Women's Health |
363LW0102X | 50 | Nurse Practitioner |
| NPI Number | 1790378487 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/15/2021 | |
| Last updated | 02/15/2021 - About 5 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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RIVERS EDGE PRIMARY CARE LLC
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