Provider Demographics
NPI:1598114274
Name:BARBOSA FELIPE, GIOVANA ELLEN (NP)
Entity Type:Individual
Prefix:
First Name:GIOVANA
Middle Name:ELLEN
Last Name:BARBOSA FELIPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:GIOVANA
Other - Middle Name:
Other - Last Name:BARBOSA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:508-334-3550
Practice Address - Fax:774-442-6715
Is Sole Proprietor?:No
Enumeration Date:2016-06-03
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2307267363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner