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General NPI Number Information
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NPI Number | 1063122935
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Entity Type | Organization
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Legal Business Name | VITALPULSE INTEGRATED HEALTH LLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 6 ESSEX CENTER DR STE 309
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City | PEABODY
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State | MA
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Zip | 01960-2907
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Country | US
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Telephone | 781-666-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 4203 WOODBRIDGE RD
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City | PEABODY
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State | MA
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Zip | 01960-4763
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Country | US
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Telephone | 978-837-2410
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. MERCY BASHIR
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Credential | DNP
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Telephone | 781-666-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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