Individual
MR. JERMAINE DARIO OKANG THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AGPCNP-BC
Contact information
Practice address
801 MASSACHUSETTS AVE, 2ND FL, BOSTON, MA 02118-0211
(617) 414-7399
(617) 414-4676
Mailing address
801 ALBANY ST FL GROUND, BOSTON, MA 02119-2560
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
RN2320575
MA
363LA2100X
Acute Care Nurse Practitioner
RN2320575
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2320575
MA
Other
Enumeration date
08/04/2019
Last updated
11/11/2021
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