Individual
JANICE MARIE MICALE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
165 DARTMOUTH ST, BOSTON, MA 02116-5123
(617) 859-5000
(617) 859-5425
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
123571
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
123571
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0355330
—
MA
01
—
NP1560
BLUE CROSS
MA
01
—
PN231
HARVARD PILGRIM
MA
Enumeration date
02/24/2006
Last updated
09/11/2025
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