=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508609454
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NUDAY HEALTH SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2024
-----------------------------------------------------
Last Update Date | 07/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 56 CHERRY ST FL 2
-----------------------------------------------------
City | BROCKTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02301-2608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-522-1763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 177 HUNGTON AVE STE 1703
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-522-1763
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AUDREY USRY
-----------------------------------------------------
Credential | FNP
-----------------------------------------------------
Telephone | 678-522-1763
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------