Healthcare Provider Details

I. General information

NPI: 1619399425
Provider Name (Legal Business Name): CHERYL NEILSEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERYL BELANGER NP

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 OLD AMHERST RD
BELCHERTOWN MA
01007-9745
US

IV. Provider business mailing address

145 OLD AMHERST RD
BELCHERTOWN MA
01007-9745
US

V. Phone/Fax

Practice location:
  • Phone: 413-253-9777
  • Fax: 413-253-7290
Mailing address:
  • Phone: 413-253-9777
  • Fax: 413-253-7290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2276342
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2276342
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN2276342
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: