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NPI Code Detail

MEDICARE: MRS. PATRICIA M GUSTIN NP

MEDICARE: MRS. PATRICIA M GUSTIN 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
1163W00000XRegistered Nurse193678MA
2363LX0001XObstetrics & Gynecology Nurse PractitionerRN193678MA

General Provider Information

NPI Number : 1417931452
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA M GUSTIN NP
Provider Business Mailing Address
First Line : 13 TALL TIMBERS LN
Second Line :
City : KINGSTON
State : MA
Zip : 02364-1855
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 135 WEBSTER ST
Second Line :
City : HANOVER
State : MA
Zip : 02339-1200
Country : US
Telephone Number : 781-878-7020
Fax Number : 781-871-3590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 01/26/2018

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