Individual
MS. LOUISA LEA JELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC, MSN, NNP
Contact information
Practice address
750 WASHINGTON ST, BOX # 300, BOSTON, MA 02111-1526
(617) 636-5008
(617) 636-9653
Mailing address
15 CARRIAGE LN, READING, MA 01867-1373
(781) 942-0115
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
115843
MA
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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