Healthcare Provider Details

I. General information

NPI: 1164778890
Provider Name (Legal Business Name): KARYN LYNN ROSSACCI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WRIGHT ST WING MEMORIAL HOSPITAL
PALMER MA
01069-1138
US

IV. Provider business mailing address

60 HOSPITAL RD WING EMERGENCY SERVICES
LEOMINSTER MA
01453-2205
US

V. Phone/Fax

Practice location:
  • Phone: 413-294-5308
  • Fax: 413-284-5704
Mailing address:
  • Phone: 978-466-2994
  • Fax: 978-466-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN256683
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: