Healthcare Provider Details

I. General information

NPI: 1811381437
Provider Name (Legal Business Name): NERHC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PRESCOTT ST SUITE 101
WORCESTER MA
01605-2610
US

IV. Provider business mailing address

85 PRESCOTT ST SUITE 101
WORCESTER MA
01605-2610
US

V. Phone/Fax

Practice location:
  • Phone: 508-890-5633
  • Fax: 508-890-1125
Mailing address:
  • Phone: 508-890-5633
  • Fax: 508-890-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberMA168131
License Number StateMA

VIII. Authorized Official

Name: DIANNA MARKLEY
Title or Position: ADMINISTRATOR
Credential: SN
Phone: 508-890-5633