Healthcare Provider Details

I. General information

NPI: 1689246142
Provider Name (Legal Business Name): NINA GABRIELA LOW PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CEDAR ST
WORCESTER MA
01609-4101
US

IV. Provider business mailing address

55 CEDAR ST
WORCESTER MA
01609-4101
US

V. Phone/Fax

Practice location:
  • Phone: 978-393-1434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2339813
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberRN23948562
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code364SP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN2339813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: