Basic Information
| Provider Information | |||||||||
| NPI: | 1619432531 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MULVEY-SYLVIA | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 237 STATE ROAD | ||||||||
| Address2: | |||||||||
| City: | DARTMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087178903 | ||||||||
| FaxNumber: | 5089939985 | ||||||||
| Practice Location | |||||||||
| Address1: | 237 STATE ROAD | ||||||||
| Address2: | |||||||||
| City: | DARTMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087178903 | ||||||||
| FaxNumber: | 5089939985 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2019 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN22273229-CNP | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.