Basic Information
| Provider Information | |||||||||
| NPI: | 1649891276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BJORK | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Credential: | MS, AGNP-C, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 DAVIS LN | ||||||||
| Address2: | |||||||||
| City: | GEORGETOWN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018331336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782732906 | ||||||||
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| Practice Location | |||||||||
| Address1: | 55 FOGG RD | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021902432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816248000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2020 | ||||||||
| LastUpdateDate: | 05/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | RN2335052 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LA2200X | RN2335052 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.