Healthcare Provider Details

I. General information

NPI: 1013451921
Provider Name (Legal Business Name): CHARMY PATEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 LOON HILL RD STE 301
DRACUT MA
01826-4365
US

IV. Provider business mailing address

9 LOON HILL RD STE 301
DRACUT MA
01826-4365
US

V. Phone/Fax

Practice location:
  • Phone: 978-323-0360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number068603-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2287384
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: