Healthcare Provider Details

I. General information

NPI: 1962019117
Provider Name (Legal Business Name): ANACELIS FLECHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 09/30/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LOCUST ST
NORTHAMPTON MA
01060-2093
US

IV. Provider business mailing address

127 CORCORAN BLVD
SPRINGFIELD MA
01118-2407
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-9866
  • Fax: 413-923-9306
Mailing address:
  • Phone: 413-391-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN2279901
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2279901
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: