Individual
MS. REBECCA ANN NISBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNS-BC
Contact information
Practice address
607 NORTH AVE, #14 2ND FLOOR, WAKEFIELD, MA 01880-1306
(781) 246-0020
(781) 587-1397
Mailing address
607 NORTH AVE, #14, 2ND FLOOR, WAKEFIELD, MA 01880-1306
(781) 246-0020
(781) 587-1397
Taxonomy
Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
113629PC
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216172000
MAGELLAN
—
01
—
308581
MHN (TRICARE)
—
01
—
PN0654
BCBS
MA
Enumeration date
09/08/2006
Last updated
03/30/2010
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