Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN2306579 | MA |
NPI | 1013447432 |
---|---|
Provider Name | Cassandra Nava |
First Address | Providence, RI 02905-1939 |
Second Address | Springfield, MA 01104-3736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 18/06/2017 |