Healthcare Provider Details

I. General information

NPI: 1386953792
Provider Name (Legal Business Name): SARAH DENSON POIRIER APRN/BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2010
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 MAIN ST
ATHOL MA
01331-1846
US

IV. Provider business mailing address

491 MAIN ST
ATHOL MA
01331-1846
US

V. Phone/Fax

Practice location:
  • Phone: 978-459-2306
  • Fax:
Mailing address:
  • Phone: 978-249-2784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN183448NP
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: