Healthcare Provider Details

I. General information

NPI: 1083589808
Provider Name (Legal Business Name): VITAL PATH WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PLEASANT ST
FALL RIVER MA
02721-3018
US

IV. Provider business mailing address

215 PLEASANT ST
FALL RIVER MA
02721-3018
US

V. Phone/Fax

Practice location:
  • Phone: 508-812-5120
  • Fax:
Mailing address:
  • Phone: 508-812-5120
  • Fax: 539-239-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETE RODRIGUES
Title or Position: FAMILY NURSE PRACTITIONER
Credential: APRN
Phone: 508-812-5120