Individual
EMILY-ROSE MONTGOMERY VIRDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
331 WEST GROVE STREET, STE 4, MIDDLEBORO, MA 02346-0234
(857) 330-6565
(857) 330-6566
Mailing address
331 WEST GROVE STREET, STE 4, MIDDLEBORO, MA 02346-5230
(857) 330-6565
(857) 330-6566
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2292320
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2292320
MA
Other
Enumeration date
09/03/2015
Last updated
06/30/2021
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