Healthcare Provider Details

I. General information

NPI: 1588346217
Provider Name (Legal Business Name): MAGGIE PANETTI PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MYRON ST STE A
WEST SPRINGFIELD MA
01089-1485
US

IV. Provider business mailing address

49 SUNNYMEADE AVE
CHICOPEE MA
01020-1737
US

V. Phone/Fax

Practice location:
  • Phone: 413-592-1980
  • Fax: 413-225-8547
Mailing address:
  • Phone: 413-519-4907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN256679
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN256679
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: