Healthcare Provider Details

I. General information

NPI: 1013707843
Provider Name (Legal Business Name): ABIGAIL BLISS WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WASHINGTON ST STE 764
NEWTON MA
02462-1628
US

IV. Provider business mailing address

2000 WASHINGTON ST STE 764
NEWTON MA
02462-1628
US

V. Phone/Fax

Practice location:
  • Phone: 617-965-7800
  • Fax:
Mailing address:
  • Phone: 617-965-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2390325
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN2390325
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: