Provider Demographics
NPI:1851784193
Name:ESTEVEZ, ROMA Y (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ROMA
Middle Name:Y
Last Name:ESTEVEZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:ROMA
Other - Last Name:ESTEVEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1138
Practice Address - Country:US
Practice Address - Phone:413-284-5285
Practice Address - Fax:413-284-5384
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN270667363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health