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MARISSA PROVENCHER
NPI 1023966934
Registered Nurse - Ambulatory Care in Boston, MA

Active since March 17, 2026
930 COMMONWEALTH AVE, BOSTON, MA 02215(617) 414-6800(617) 414-6800 Get Directions Write a Review

NPPES record last updated: March 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Marissa Provencher NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA PROVENCHER (NPI 1023966934) is an individual ambulatory care provider in Boston, Massachusetts, licensed in Massachusetts (RN2343674) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1023966934
Entity TypeIndividualFemale
Primary Taxonomy163WP2201X
Provider Legal NameMARISSA PROVENCHER
Location Address930 COMMONWEALTH AVEBoston, MA 02215-1274
Mailing Address1 Arbroth StBoston, MA 02122-2511 · (603) 401-2389
Phone(617) 414-6800
Fax(617) 414-6800
Sole ProprietorNo
Enumeration DateMarch 17, 2026
NPPES CertifiedMarch 17, 2026
✔ NPI 1023966934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Ambulatory CareNursing Service Providers
Taxonomy Code163WP2201X
License✔ Licensed in MA · RN2343674
930 COMMONWEALTH AVE, Boston, MA 02215
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRITTNEY JAYE MAZZA O.D.
Optometrist
930 COMMONWEALTH AVE, SUITE 2A
BOSTON, MA 02215
Suffolk County (617) 262-2020
DR. RAJVINDER KAUR PABLA OD
Optometrist (Pediatrics)
930 COMMONWEALTH AVE, SUITE 2A
BOSTON, MA 02215
Suffolk County (617) 529-9077
MS. JENNFIER KALDENBERG O.T.
Occupational Therapist
930 COMMONWEALTH AVE
BOSTON, MA 02215
Suffolk County (617) 262-2020
DR. TIMOTHY J BOSSIE O.D.
Optometrist
930 COMMONWEALTH AVE
BOSTON, MA 02215
Suffolk County (617) 262-2020
DR. MARGARET ROSE ERRANTE D.D.S.
Dentist (General Practice)
930 COMMONWEALTH AVE
BOSTON, MA 02215
Suffolk County (617) 358-1000
DR. ELIZABETH PALLANTE OD
Optometrist
930 COMMONWEALTH AVE
BOSTON, MA 02215
Suffolk County (617) 262-2020
MS. KARA ELIZABETH GERGER O.D.
Optometrist
930 COMMONWEALTH AVE, SUITE 2A
BOSTON, MA 02215
Suffolk County (617) 262-2020
DR. ALI ABDALLAH BDS, CAGS, DSCD, FAC
Dentist (Prosthodontics)
930 COMMONWEALTH AVE
BOSTON, MA 02215
Suffolk County (617) 358-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Provencher's NPI number?

The NPI number for Marissa Provencher is 1023966934. It was assigned to this individual provider in the NPPES registry on March 17, 2026.

Where is Marissa Provencher located?

Marissa Provencher practices at 930 Commonwealth Ave, Boston, MA 02215. The listed phone number is (617) 414-6800.

What is Marissa Provencher's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Ambulatory Care, with taxonomy code 163WP2201X.

When was this NPI record last updated?

The NPPES record for Marissa Provencher was last updated on March 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.