Healthcare Provider Details

I. General information

NPI: 1215924337
Provider Name (Legal Business Name): JENNIFER L RAPOZA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HANOVER ST
FALL RIVER MA
02720-5444
US

IV. Provider business mailing address

200 MILL RD STE 180
FAIRHAVEN MA
02719-5252
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-8612
  • Fax: 508-973-8615
Mailing address:
  • Phone: 508-973-2000
  • Fax: 508-973-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number211703
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: