Healthcare Provider Details

I. General information

NPI: 1568262921
Provider Name (Legal Business Name): BONNIE FOOTE-KASSIN RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HOPE AVE
WORCESTER MA
01603-2212
US

IV. Provider business mailing address

8 LONG POND DR
DRACUT MA
01826-3012
US

V. Phone/Fax

Practice location:
  • Phone: 774-303-1217
  • Fax:
Mailing address:
  • Phone: 978-421-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number081138-21
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2334299
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2334299
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: