Individual
JACQUELINE SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
230 MAPLE ST, HOLYOKE, MA 01040-5124
(413) 420-2200
(413) 420-2260
Mailing address
PO BOX 6260, 230 MAPLE ST, HOLYOKE, MA 01041-6260
(413) 420-2200
(413) 420-2260
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77663
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010026
NEIGHBORHOOD HEALTH PLAN
MA
01
—
8339
BOSTON HEALTH NET
MA
01
—
976243
NETWORK HEALTH
MA
01
—
SPJ18312
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/26/2006
Last updated
10/17/2011
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