Provider Demographics
NPI:1356002018
Name:XYLIA, LLC
Entity Type:Organization
Organization Name:XYLIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:617-640-3857
Mailing Address - Street 1:58 JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4915
Mailing Address - Country:US
Mailing Address - Phone:617-640-3857
Mailing Address - Fax:
Practice Address - Street 1:58 JERSEY ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4915
Practice Address - Country:US
Practice Address - Phone:617-640-3857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty