Individual provider · Type 1 NPI
Marissa Provencher
Ambulatory Care Registered Nurse · Boston, MA
NPI number
1023966934
Active
Practice location
930 Commonwealth Ave
Boston, MA 02215-1274
Fax (617) 414-6817
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Care Registered Nurse Primary | 163WP2201X | RN2343674 (MA) |
Ambulatory Care Registered Nurse: Definition to come...
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About NPI 1023966934
Marissa Provencher's National Provider Identifier is 1023966934, issued on Mar 17, 2026. The primary taxonomy on file is Ambulatory Care Registered Nurse (163WP2201X), and the practice location is in Boston, MA. The record was last updated on Oct 21, 2026.