Provider Demographics
NPI:1154194538
Name:CHIDARIKIRE, MACRINA S (APRN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MACRINA
Middle Name:S
Last Name:CHIDARIKIRE
Suffix:
Gender:F
Credentials:APRN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:704 CHELMSFORD ST APT 303
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-5116
Mailing Address - Country:US
Mailing Address - Phone:978-809-6172
Mailing Address - Fax:
Practice Address - Street 1:847 ROGERS ST STE 201
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-4345
Practice Address - Country:US
Practice Address - Phone:978-809-6172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN283610363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health