| Raquel Humphrey, | |
|
110 Liberty St, Brockton, MA 02301-5674 | |
| (508) 941-7100 | |
| Not Available |
| Full Name | Raquel Humphrey |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 110 Liberty St, Brockton, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194595801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 353013 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN2390456 (Massachusetts) | Primary |
| Entity Name | Signature Healthcare Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508804949 PECOS PAC ID: 7719876267 Enrollment ID: O20040312000372 |
| Entity Name | Signature Healthcare Urgent Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295595700 PECOS PAC ID: 5799228060 Enrollment ID: O20240615000011 |
| Mailing Address | Practice Location Address |
|---|---|
| Raquel Humphrey, 680 Centre St, Brockton, MA 02302-3308 Ph: (508) 941-7100 | Raquel Humphrey, 110 Liberty St, Brockton, MA 02301-5674 Ph: (508) 941-7100 |
Christine Nichole Lattuada, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Pearl St, Suite 2000, Brockton, MA 02301 Phone: 508-894-8577 Fax: 508-894-8578 | |
Rebecca Match, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Meadowbrook Rd, Brockton, MA 02301 Phone: 508-638-6006 | |
Jessica Santiccioli, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 63 Main St, Brockton, MA 02301 Phone: 508-559-6699 | |
Mrs. Henrietta Amaka Ewuzie, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14 Heritage Ct, Brockton, MA 02302 Phone: 857-233-1890 | |
Mrs. Rena B Levy, MSN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 110 Liberty St, Brockton, MA 02301 Phone: 508-894-0400 Fax: 508-894-0412 | |
Lauren Kaplan, CPNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1324 Belmont St Ste 105, Brockton, MA 02301 Phone: 617-571-6732 | |
Susanne Adams, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 158 Pleasant St, Brockton, MA 02301 Phone: 508-894-3363 |