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General NPI Number Information
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NPI Number | 1750799326
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Entity Type | Organization
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Legal Business Name | IASIS SOLUTIONS
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 50 LEXINGTON ST # 2
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City | FRAMINGHAM
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State | MA
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Zip | 01702-8219
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Country | US
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Telephone | 617-454-4186
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Fax |
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Provider Business Mailing Address
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Address Line | 803 WINDSOR DR
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5007
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Country | US
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Telephone | 774-414-4186
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MISS VIRGINIA NDORO
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Credential |
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Telephone | 671-454-4186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN27515
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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