Individual
KIM DA SILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RN
Contact information
Practice address
323 N MAIN ST, UXBRIDGE, MA 01569-1757
(508) 852-1805
(508) 853-8593
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2263026
MA
363L00000X
Nurse Practitioner
RN2263026
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2263026
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301071
GROUP MEDICAID NUMBER
MA
Enumeration date
01/05/2010
Last updated
03/28/2016
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