Bridgecare Provider Group Ma, PLLC
Nurse Practitioner in Concord, MA. Organization (NPI-2).
NPI number1679366298
StatusActive
Last updated in NPPESMay 27, 2025
Details
- NPI
- 1679366298
- Entity type
- Organization (NPI-2)
- Legal business name
- Bridgecare Provider Group Ma, PLLC
- Organization subpart
- No
- Enumeration date
- May 27, 2025
- Certification date
- May 27, 2025
- Last updated
- May 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
57 Old Road To 9 Acre CorConcord, MA 01742-3317
Phone 551-337-3278
Mailing address
57 Old Road To 9 Acre CorConcord, MA 01742-3317
Phone 551-337-3278
Authorized official
Marivic Vanover (Jed) Vanover
Vice President Of Operation
8564483533
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