1295925527 NPI number — MRS. PHOEBE ELIZABETH MORAIS RN, MSN, ANP-BC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295925527 NPI number — MRS. PHOEBE ELIZABETH MORAIS RN, MSN, ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORAIS
Provider First Name:
PHOEBE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, 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:
MURRAY
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
P
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, MSN, ANP-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1295925527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
874 PURCHASE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BEDFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02740-6232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-992-6553
Provider Business Mailing Address Fax Number:
508-984-8420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
874 PURCHASE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-6232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-992-6553
Provider Business Practice Location Address Fax Number:
508-984-8420
Provider Enumeration Date:
08/01/2007

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:  268114 , 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: 177164 . This is a "CMSP/HS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: N/A . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 007627 . This is a "SENIOR WHOLE HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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