Healthcare Provider Details

I. General information

NPI: 1316627045
Provider Name (Legal Business Name): ADVANCED VITAL BEING HEALTH & WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 FAUNCE CORNER MALL RD UNIT 220
DARTMOUTH MA
02747-1295
US

IV. Provider business mailing address

88 FAUNCE CORNER MALL RD UNIT 220
DARTMOUTH MA
02747-1295
US

V. Phone/Fax

Practice location:
  • Phone: 508-938-9670
  • Fax: 508-938-9652
Mailing address:
  • Phone: 508-938-9670
  • Fax: 508-938-9652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RACHEL E. RESENDES
Title or Position: NP
Credential:
Phone: 508-938-9670