Individual
NICE NABITAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
40 WRIGHT ST, PALMER, MA 01069-1138
(413) 370-5400
(413) 370-5654
Mailing address
280 CHESTNUT ST FL 2, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2267615
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110028120
—
MA
01
—
MN0955813I
CONTROLLED SUBSTANCE REGISTRATION
MA
Enumeration date
05/02/2014
Last updated
03/07/2023
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