Individual
GRACE MBUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
120 STAFFORD ST, WORCESTER, MA 01603-1457
(508) 344-7530
Mailing address
21 SW CUTOFF, NORTHBOROUGH, MA 01532-2135
(508) 344-7530
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
284646
MA
363L00000X
Nurse Practitioner
Primary
RN284646
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
316951
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN284646
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PIDSL110186617A
—
MA
Enumeration date
08/13/2014
Last updated
04/11/2025
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