Provider Demographics
NPI:1225826381
Name:DEBOSE, FELISHA NICOLE
Entity type:Individual
Prefix:
First Name:FELISHA
Middle Name:NICOLE
Last Name:DEBOSE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 KENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1973
Mailing Address - Country:US
Mailing Address - Phone:413-223-5072
Mailing Address - Fax:413-773-3972
Practice Address - Street 1:21 KENWOOD ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1973
Practice Address - Country:US
Practice Address - Phone:413-223-5072
Practice Address - Fax:413-773-3972
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10023230163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse