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General NPI Number Information
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NPI Number | 1801449863
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Entity Type | Individual
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Provider Name | MASSIEL REYES FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 47 CONGRESS ST
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City | SALEM
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State | MA
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Zip | 01970-7308
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Country | US
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Telephone | 978-744-8388
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Fax |
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Provider Business Mailing Address
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Address Line | 15 CHARLOTTE ST
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City | PEABODY
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State | MA
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Zip | 01960-6053
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Country | US
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Telephone | 978-907-3319
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2287325
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License Number State | MA
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