Individual
ELIZABETH HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
230 WORCESTER ST, WELLESLEY, MA 02481-5420
(781) 431-5200
(781) 431-5298
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
162680
MA
363LF0000X
Family Nurse Practitioner
Primary
162680
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360091
—
MA
01
—
NP1808
BLUE CROSS
MA
01
—
PN803
HARVARD PILGRIM
MA
Enumeration date
02/15/2006
Last updated
10/11/2013
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