Provider Demographics
NPI:1710055066
Name:ORTIZ, MARIBEL (APRN)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6425
Mailing Address - Country:US
Mailing Address - Phone:978-337-7135
Mailing Address - Fax:
Practice Address - Street 1:5 WALLACE ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6425
Practice Address - Country:US
Practice Address - Phone:978-221-7598
Practice Address - Fax:978-372-6173
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212785363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner