MRS. ANN OSAMUDIAIMEN IRORERE NURSE PRACTITIONER NPI 1114203767

NPI Information

NPI: 1114203767
Provider Name: MRS. ANN OSAMUDIAIMEN IRORERE, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
155 SOUTH LEYDEN ST
BROCKTON, MA
ZIP 02302
Phone: (508) 345-6313
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MRS. Ann Osamudiaimen Irorere, NURSE PRACTITIONER is a psychiatric/mental health nurse practitioner in Brockton, MA. MRS. Ann Osamudiaimen Irorere, NURSE PRACTITIONER NPI is 1114203767. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

155 SOUTH LEYDEN ST
BROCKTON, MA
ZIP 02302
Phone: (508) 345-6313

The NPI 1114203767 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/27/2011 and was last updated on 1/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	N2257719	MASSACHUSETTS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	RN2257719	MASSACHUSETTS	Yes
3	163W00000X	Registered Nurse		RN2257719	MASSACHUSETTS	No
4	363LA2200X	Nurse Practitioner	Adult Health	RN2257719	MASSACHUSETTS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	163W00000X	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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