Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN265055 | MA |
N | 363LC1500X | Nurse Practitioner - Community Health | RN265055 | MA |
NPI | 1124407945 |
---|---|
Provider Name | Nancy Njema Atimbo |
First Address | Chicopee, MA 01020-4029 |
Second Address | Chicopee, MA 01020-4029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 29/05/2015 |