1851468581 NPI number — MARILYNN NEWCOMB ANP - BC

Table of content: MARILYNN NEWCOMB ANP - BC (NPI 1851468581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851468581 NPI number — MARILYNN NEWCOMB ANP - BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWCOMB
Provider First Name:
MARILYNN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ANP - BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851468581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
667 PLYMOUTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITMAN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02382-1634
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-447-6887
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HEALTH SERVICES BRIDGEWATER STATE COLLEGE
Provider Second Line Business Practice Location Address:
45 SCHOOL ST
Provider Business Practice Location Address City Name:
BRIDGEWATER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02325-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-531-1252
Provider Business Practice Location Address Fax Number:
508-531-6193
Provider Enumeration Date:
11/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  96777 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)