Doctor Name: | COLLEEN A VISCARRA |
NPI Number: | 1427309640 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | RN260410 |
Business Practice Address: | 131 Emerald St Wrentham Developmental Center Wrentham, MA - 020931902 |
Business Phone Number: | 5083845525 |
Business Fax Number: | |
Mailing Address: | 131 Emerald Street, Wrentham Developmental Center WRENTHAM |
State: | MA |
Postal Code: | 02093 |
Phone Number: | 5083845525 |
Fax Number: | |
NPI Enumeration Date: | 09/27/2012 |
NPI Last Update Date: | 09/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | RN260410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |