Healthcare Provider Details

I. General information

NPI: 1659108074
Provider Name (Legal Business Name): NORTHEAST PROFESSIONAL REGISTRY OF NURSES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ALUMNI DR
EXETER NH
03833-2118
US

IV. Provider business mailing address

800 W CUMMINGS PARK STE 5000
WOBURN MA
01801-6356
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-2981
  • Fax:
Mailing address:
  • Phone: 978-712-1309
  • Fax: 781-756-2654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH COSTELLO
Title or Position: COO
Credential:
Phone: 978-712-1233