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General NPI Number Information
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NPI Number | 1558316380
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Entity Type | Individual
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Provider Name | ELZIRA A DEOLIVEIRA PCNS
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Gender | Female
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 40 SPRUCE STREET
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City | LEOMINSTER
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State | MA
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Zip | 01453-3361
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Country | US
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Telephone | 800-977-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 298 HOWARD STREET SUITE 100
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8313
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Country | US
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Telephone | 508-879-2250
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Fax | 508-620-2637
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 186008
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License Number State | MA
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