MOON SPOT WELLNESS CENTER PC NPI 1447741350

NPI Information

NPI: 1447741350
Provider Name: MOON SPOT WELLNESS CENTER PC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
36 N BEDFORD ST STE 3
EAST BRIDGEWATER, MA
ZIP 02333
Phone: (508) 735-9406
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MOON SPOT WELLNESS CENTER PC is a psychiatric/mental health nurse practitioner in East Bridgewater, MA. MOON SPOT WELLNESS CENTER PC NPI is 1447741350. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

36 N BEDFORD ST STE 3
EAST BRIDGEWATER, MA
ZIP 02333-186
Phone: (508) 735-9406
Fax: (774) 568-5605

The provider's authorized official is Mechelle Plasse .
The authorized official title is Advanced Practice Nurse Practitione and has the following contact phone number (508) 735-9406.

The enumeration date for this NPI number is 5/25/2018 and was last updated on 5/25/2018.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	176838	MASSACHUSETTS	Yes

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	PN0618	OTHER	MASSACHUSETTS	BLUE CROSS
2	176838	OTHER	MASSACHUSETTS	APRN LICENSE
3	1854984	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

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