MISS MARI AGNES STACKPOOLE NP NPI 1790013910

NPI Information

NPI: 1790013910
Provider Name: MISS MARI AGNES STACKPOOLE, NP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1261 FURNACE BROOK PKWY
SUITE 30-31
QUINCY, MA
ZIP 02169
Phone: (617) 479-4545
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MISS Mari Agnes Stackpoole, NP is an adult health nurse practitioner in Quincy, MA with 15 years of experience. MISS Mari Agnes Stackpoole, NP NPI is 1790013910. 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:

1261 FURNACE BROOK PKWY
SUITE 30-31
QUINCY, MA
ZIP 02169-721
Phone: (617) 479-4545
Fax: (617) 479-4555

The NPI 1790013910 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 11/28/2009 and was last updated on 1/9/2020.

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	163W00000X	Registered Nurse		280880	MASSACHUSETTS	No
2	363LA2200X	Nurse Practitioner	Adult Health	280880	MASSACHUSETTS	Yes
3	363LG0600X	Nurse Practitioner	Gerontology	280880	MASSACHUSETTS	No

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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