Provider Demographics
NPI:1669250817
Name:BARTZ, ELOISE (MSN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ELOISE
Middle Name:
Last Name:BARTZ
Suffix:
Gender:F
Credentials:MSN PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-5742
Mailing Address - Country:US
Mailing Address - Phone:828-329-6718
Mailing Address - Fax:
Practice Address - Street 1:50 COMMONWEALTH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3085
Practice Address - Country:US
Practice Address - Phone:617-235-2193
Practice Address - Fax:617-536-0324
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2350136363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health