Provider Demographics
NPI:1588346217
Name:PANETTI, MAGGIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:PANETTI
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 SUNNYMEADE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1737
Mailing Address - Country:US
Mailing Address - Phone:413-519-4907
Mailing Address - Fax:
Practice Address - Street 1:103 MYRON ST STE A
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1485
Practice Address - Country:US
Practice Address - Phone:413-592-1980
Practice Address - Fax:413-225-8547
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN256679163WS0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool