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General NPI Number Information
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NPI Number | 1255695912
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Entity Type | Individual
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Provider Name | ANTONETTE M COMEAU N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 819 WORCESTER ST SUITE 3
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City | SPRINGFIELD
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State | MA
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Zip | 01151-1045
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Country | US
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Telephone | 978-618-6946
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Fax |
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Provider Business Mailing Address
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Address Line | 34 LIBERTY LN
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City | ASHBURNHAM
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State | MA
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Zip | 01430-1436
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Country | US
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Telephone | 978-618-6946
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN278694
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN278694
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | RN278694
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License Number State | MA
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