MEDICARE: MRS. MARINETE HENRY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN264251	MA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN264251	MA

General Provider Information

NPI Number	:	1093241010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARINETE HENRY NP

Provider Business Mailing Address
First Line	:	805 TURNPIKE ST STE 101
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-6122
Country	:	US
Telephone Number	:	978-401-4444
Fax Number	:	978-209-2808

Provider Business Practice Location Address
First Line	:	805 TURNPIKE ST STE 101
Second Line	:
City	:	NORTH ANDOVER
State	:	MA
Zip	:	01845-6122
Country	:	US
Telephone Number	:	978-401-4444
Fax Number	:	978-209-2808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	05/06/2024

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