Healthcare Provider Details

I. General information

NPI: 1033620992
Provider Name (Legal Business Name): ERICA BARBOZA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 HODGES AVE
TAUNTON MA
02780-3034
US

IV. Provider business mailing address

942 W CHESTNUT ST
BROCKTON MA
02301-5567
US

V. Phone/Fax

Practice location:
  • Phone: 508-583-3005
  • Fax:
Mailing address:
  • Phone: 508-583-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN2267309
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: