Provider Demographics
NPI:1306965645
Name:PASSERI, ESTELLE ELIZABETH (NP)
Entity type:Individual
Prefix:MRS
First Name:ESTELLE
Middle Name:ELIZABETH
Last Name:PASSERI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ESTELLE
Other - Middle Name:EIZABETH
Other - Last Name:HARMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:160 ELM ST.
Mailing Address - Street 2:
Mailing Address - City:BYFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01922
Mailing Address - Country:US
Mailing Address - Phone:978-683-4000
Mailing Address - Fax:
Practice Address - Street 1:25 MARSTON ST APT 204
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2357
Practice Address - Country:US
Practice Address - Phone:978-683-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN96496363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2724Medicare ID - Type UnspecifiedMEDICARE B