Provider Demographics
NPI:1881897767
Name:BERKSHIRE NURSE PRATITIONERS, LLC
Entity type:Organization
Organization Name:BERKSHIRE NURSE PRATITIONERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:413-447-7511
Mailing Address - Street 1:610 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4105
Mailing Address - Country:US
Mailing Address - Phone:413-447-7511
Mailing Address - Fax:
Practice Address - Street 1:610 NORTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4105
Practice Address - Country:US
Practice Address - Phone:413-447-7511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA661547OtherTUFTS
MAM19195OtherBCBS OF MASS
MA10013041OtherCDPHP
MA00033474OtherHEALTHNET
MA00033474OtherBOSTON MEDICAL CENTER
MA9755730Medicaid
MA=========OtherTRICARE
MA00033474OtherBOSTON MEDICAL CENTER
MA10013041OtherCDPHP
MADF8717Medicare UPIN