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General NPI Number Information
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NPI Number | 1104504430
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Entity Type | Individual
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Provider Name | MARIE LAUDIE NELSON RN
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Gender | Female
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 225 FOXBOROUGH BLVD STE 201
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City | FOXBOROUGH
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State | MA
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Zip | 02035-3062
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Country | US
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Telephone | 774-485-5499
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WELLESLEY ST STE 1
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City | WESTON
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State | MA
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Zip | 02493-1571
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Country | US
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Telephone | 917-916-7884
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | RN2265033
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License Number State | MA
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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 | RN2265033
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License Number State | MA
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