Doctor Name: | GRACE S TRIVERS |
NPI Number: | 1306828512 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN-BC |
License Number: | 119209 |
Business Practice Address: | 73 Princeton St Suite 203 North Chelmsford, MA - 018631558 |
Business Phone Number: | 9782566579 |
Business Fax Number: | 9782561943 |
Mailing Address: | 73 Princeton St, Suite 203 NORTH CHELMSFORD |
State: | MA |
Postal Code: | 018631558 |
Phone Number: | 9782566579 |
Fax Number: | 9782561943 |
NPI Enumeration Date: | 11/15/2005 |
NPI Last Update Date: | 05/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0808X |
License Number: | 119209 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |