Provider Demographics
NPI:1467286906
Name:QUASHIE, NICOLETTE DARLENE (NP)
Entity type:Individual
Prefix:MS
First Name:NICOLETTE
Middle Name:DARLENE
Last Name:QUASHIE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BRIDLE PATH CIR APT B
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4456
Mailing Address - Country:US
Mailing Address - Phone:617-922-5171
Mailing Address - Fax:
Practice Address - Street 1:1 FRANK LEARY WAY STE 1
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4503
Practice Address - Country:US
Practice Address - Phone:781-269-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2294948363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health