Individual provider Active NPI

Wendy Beth Eisan-Labelle

  • Licensed Practical Nurse
  • Brockton, MA
National Provider Identifier
1548059173
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN100734 Issued in MA
Practice address
231 Main St
Brockton, MA 02301-4342
Phone
(413) 301-9355
NPI assigned
May 1, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN100734 MA Primary

Addresses

Primary practice location

231 Main St
Brockton, MA 02301-4342

Mailing address

231 Main St
Brockton, MA 02301-4342
Phone (413) 301-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LN100734MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1548059173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "413-301-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014342",
            "telephone_number": "413-301-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISAN-LABELLE",
        "first_name": "WENDY",
        "middle_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN100734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.