Healthcare Provider Details

I. General information

NPI: 1376515650
Provider Name (Legal Business Name): DENISE M RAINVILLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WORCESTER STREET, SUITE 3 IPC HOSPITALISTS OF NEW ENGLAND, PC
SPRINGFIELD MA
01151
US

IV. Provider business mailing address

819 WORCESTER STREET, SUITE 3 IPC HOSPITALISTS OF NEW ENGLAND, PC
SPRINGFIELD MA
01151
US

V. Phone/Fax

Practice location:
  • Phone: 413-543-6820
  • Fax: 413-543-7962
Mailing address:
  • Phone: 413-543-6820
  • Fax: 413-543-7962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number207287
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: