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General NPI Number Information
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NPI Number | 1457546657
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Entity Type | Individual
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Provider Name | M. SHEILA PRENDEVILLE NP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 116 COURT ST STE 1
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City | PLYMOUTH
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State | MA
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Zip | 02360-8710
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Country | US
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Telephone | 87-471-3185
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Fax | 508-747-1410
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Provider Business Mailing Address
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Address Line | 116 COURT ST STE 1
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City | PLYMOUTH
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State | MA
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Zip | 02360-8710
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Country | US
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Telephone | 508-477-1318
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Fax | 508-747-1410
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 260795
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License Number State | MA
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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 | MP06906831
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License Number State | MA
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