MEDICARE: ANASTASIA M. HALLISEY CNM

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	367A00000X	Advanced Practice Midwife	RN267062	MA

General Provider Information

NPI Number	:	1548261456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA M. HALLISEY CNM

Provider Business Mailing Address
First Line	:	280 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	SPRINGFIELD
State	:	MA
Zip	:	01199-1001
Country	:	US
Telephone Number	:	413-794-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 MAIN ST
Second Line	:	SUITE 4D
City	:	SPRINGFIELD
State	:	MA
Zip	:	01107-1112
Country	:	US
Telephone Number	:	413-794-8336
Fax Number	:	413-794-7345

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	01/26/2018

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