Individual
JESSICA FERNANDES CANUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
45 EDSON ST, BROCKTON, MA 02302-4109
(774) 274-1882
Mailing address
45 EDSON ST, BROCKTON, MA 02302-4109
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
RN2361476
MA
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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