1962444992 NPI number — MS. JANICE MARTHA WESTER APRN-BC, PMHCNS-BC

Table of content: MS. JANICE MARTHA WESTER APRN-BC, PMHCNS-BC (NPI 1962444992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962444992 NPI number — MS. JANICE MARTHA WESTER APRN-BC, PMHCNS-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTER
Provider First Name:
JANICE
Provider Middle Name:
MARTHA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN-BC, PMHCNS-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:
1962444992
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
289 GREAT ROAD
Provider Second Line Business Mailing Address:
SUITE G1
Provider Business Mailing Address City Name:
ACTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-679-1200
Provider Business Mailing Address Fax Number:
978-486-4037

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
289 GREAT ROAD
Provider Second Line Business Practice Location Address:
SUITE G1
Provider Business Practice Location Address City Name:
ACTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-679-1200
Provider Business Practice Location Address Fax Number:
978-486-4037
Provider Enumeration Date:
06/12/2006

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: 163WP0809X , with the licence number:  158166 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 364SP0809X , with the licence number: 158166 , 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)

  • Identifier: 9939197 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1962444992 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1551904 . This is a "COVENTRY-FIRST HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 020860 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 600024931 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1962444992 . This is a "TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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