Marissa Provencher

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

RN2343674 Issued in MA

Practice address

930 Commonwealth Ave
Boston, MA 02215-1274

Phone

(617) 414-6800

Fax

(617) 414-6800

NPI assigned

Mar 17, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1023966934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ARBROTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021222511",
            "telephone_number": "603-401-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 COMMONWEALTH AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151274",
            "telephone_number": "617-414-6800",
            "fax_number": "617-414-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENCHER",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-17",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MA",
            "license": "RN2343674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Perkins Prothro
• Deborah B Prothrow-Stith, M.D.
• Alexia Proulx, P.A.
• Francesca Proulx, MD
• Laura Ashley Prout
• Audrey M Provenzano, MD
• Catarina Grace Provenzano
• Providence Living LLC
• Adam Provost, OD
• Christiana Kathleen Prucnal

• Ambulatory Care Registered Nurse in Boston, MA
• Providers in Boston, MA by specialty
• Ambulatory Care Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.