Individual
MS. JENNIFER MASSARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 769-7100
Mailing address
55 LAKE AVE N, UMASS MEMORIAL MEDICAL CENTER, PSYCHIATRY, WORCESTER, MA 01655-0002
(508) 334-3562
(508) 421-1000
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
276298
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704344082
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN276298
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
276298
LICENSE
MA
01
—
4704344082
LICENSE
MI
Enumeration date
03/22/2013
Last updated
10/25/2022
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