Provider Demographics
NPI:1437981404
Name:UHLENBROCK, JUSTINE HAIR (DNP, PMHNP-BC, MPH)
Entity type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:HAIR
Last Name:UHLENBROCK
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:575 VIRGINIA ROAD
Mailing Address - Street 2:BUIDING 3, SUITE 102
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5415
Mailing Address - Country:US
Mailing Address - Phone:978-796-6501
Mailing Address - Fax:978-288-0239
Practice Address - Street 1:575 VIRGINIA RD STE 102
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2761
Practice Address - Country:US
Practice Address - Phone:978-796-6501
Practice Address - Fax:978-288-0239
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2322532163WP0808X
MARN2322532363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health