Nancy E Deforest, NP
Individual provider Active NPI Nurse Practitioner · Wrentham, MA
NPI 1467447482 · NPPES record last updated Dec 1, 2009
Key facts
- NPI
- 1467447482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 107372 (MA)
- Practice address
- 24 Common Street,
Suite 1
Wrentham, MA 02093 - Phone
- (508) 384-2223
- Fax
- (508) 384-0066
- NPI assigned
- Sep 15, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caritas Medical Group, Inc. | Past | Accepting new patients | |
| Steward Medical Group, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 107372 | MA | Yes |
Addresses
Primary practice location
24 Common Street,
Suite 1
Wrentham, MA 02093
Mailing address
77 Warren St
Room 339
Brighton, MA 02135-3601
Phone (617) 562-5359
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0319040 | Medicaid | MA |
Other providers in Wrentham, MA
- Linda Croteau
- Christine Crowley
- CVS Pharmacy Inc
- Cynthia Louise Daigneault
- Angela Marie Dalpe
- Deepthi P Desilva
- Gina Desousa
- Iqubal S. Dhaliwal
- Andrew Joseph Dileo
- William D Dillon
All providers in Wrentham, MA · Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.