Provider Demographics
NPI:1528119989
Name:PLASSE, MECHELLE JEAN (RN CS, NP)
Entity type:Individual
Prefix:MS
First Name:MECHELLE
Middle Name:JEAN
Last Name:PLASSE
Suffix:
Gender:F
Credentials:RN CS, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:36 N BEDFORD ST
Mailing Address - Street 2:STE 3
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1186
Mailing Address - Country:US
Mailing Address - Phone:507-735-9406
Mailing Address - Fax:508-697-6999
Practice Address - Street 1:36 N BEDFORD ST
Practice Address - Street 2:SUITE #3
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1186
Practice Address - Country:US
Practice Address - Phone:508-735-9406
Practice Address - Fax:508-697-6999
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA176838363LP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1854984Medicaid
MAPN0618OtherBLUE CROSS
MA176838OtherTUFTS HEALTH PLAN NUMBER
MAS51874Medicare UPIN
MAPN0618OtherBLUE CROSS