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General NPI Number Information
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NPI Number | 1922081124
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Entity Type | Individual
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Provider Name | MYNETTE SHIFMAN NP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2005
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Last Update Date | 06/28/2025
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Provider Practice Location Address
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Address Line | 125 TURNPIKE RD STE 5
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2841
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Country | US
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Telephone | 508-595-8181
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Fax | 508-219-6521
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Provider Business Mailing Address
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Address Line | 125 TURNPIKE RD STE 5
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City | WESTBOROUGH
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State | MA
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Zip | 01581-2841
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Country | US
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Telephone | 508-595-8181
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Fax | 508-219-6521
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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 | 226216
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 226216
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License Number State | MA
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