Delisa, Rebecca Ann
Delisa, Rebecca Ann is an individual health care provider with primary practice located at 354 Birnie Ave Ste 202 , Springfield MA 01107-1109. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Delisa, Rebecca Ann can be contacted via phone (413) 733-3470.Contact Information
Primary practice address
354 Birnie Ave Ste 202
Springfield MA 01107-1109
Phone: (413) 733-3470
Fax: (413) 732-4216
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 206128 | Massachusetts |
Profile Details
| NPI number | 1033196530 |
|---|---|
| LBN Legal business name | Delisa, Rebecca Ann |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2005 |
| Last updated | Jun 6th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033196530 | NPPES |
| Massachusetts | MEDICAID | 0376060 |
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