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General NPI Number Information
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NPI Number | 1932857117
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Entity Type | Individual
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Provider Name | STEPHANIE BALZANO SOUSA MSN, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 10 EMORY ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-3089
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Country | US
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Telephone | 401-415-4200
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Fax | 401-415-4210
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Provider Business Mailing Address
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Address Line | 171 WINDWARD WAY
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City | SWANSEA
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State | MA
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Zip | 02777-1135
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Country | US
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Telephone | 401-301-0207
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | PENDING
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License Number State | RI
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