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Individual

THAIS BITENCOURT ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
41 MALL RD, BURLINGTON, MA 01805-5937
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2269373
MA
363LP2300X
Primary Care Nurse Practitioner
RN2269373
MA

Other

Enumeration date
10/27/2019
Last updated
04/23/2024
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