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General NPI Number Information
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NPI Number | 1083571749
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Entity Type | Individual
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Provider Name | EDITH PROPHETE
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 84 SIDNEY ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-2056
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Country | US
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Telephone | 781-510-3253
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Fax |
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Provider Business Mailing Address
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Address Line | 84 SIDNEY ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-2056
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Country | US
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Telephone | 781-510-3253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2339494
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License Number State | MA
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