Individual
MRS. AMARYLLIS P TEIXEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(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
363LF0000X
Family Nurse Practitioner
Primary
RN272624
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301071
GROUP NUMBER
MA
Enumeration date
09/29/2008
Last updated
12/20/2011
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