Individual
DEBRA R. SEVERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNCS
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(781) 306-5463
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(781) 306-5463
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
136533
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014858
NEIGHBORHOOD HEALTH PLAN
MA
01
—
669501
TUFTS HEALTH PLAN
MA
01
—
PN0205
BLUE CROSS
MA
Enumeration date
07/22/2006
Last updated
09/01/2009
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