Healthcare Provider Details

I. General information

NPI: 1932785011
Provider Name (Legal Business Name): ALLISON PLOURDE LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2021
Last Update Date: 03/20/2021
Certification Date: 03/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 KILBURN ST
NEW BEDFORD MA
02740-7321
US

IV. Provider business mailing address

8 KILBURN ST
NEW BEDFORD MA
02740-7321
US

V. Phone/Fax

Practice location:
  • Phone: 508-979-1122
  • Fax: 508-525-4014
Mailing address:
  • Phone: 508-979-1122
  • Fax: 508-525-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number58680
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: