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General NPI Number Information
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NPI Number | 1083464259
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Entity Type | Organization
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Legal Business Name | NURSE'S SQUARE PLLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 62 SUMMIT RD
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City | HOLBROOK
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State | MA
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Zip | 02343-2138
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Country | US
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Telephone | 508-300-7066
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Fax | 508-300-7066
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Provider Business Mailing Address
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Address Line | 62 SUMMIT RD
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City | HOLBROOK
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State | MA
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Zip | 02343-2138
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Country | US
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Telephone | 508-300-7066
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Fax | 508-300-7066
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. VANESSA MARINE FERNANDES
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Credential | MSN, FNP-BC
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Telephone | 508-300-7066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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