Individual
JESICA PAGANO-THERRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP
Contact information
Practice address
55 LAKE AVE N, PEDIATRICS, BENEDICT A3-115, WORCESTER, MA 01655-0002
(508) 334-2319
(508) 856-1733
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN267513
MA
363LP0200X
Pediatric Nurse Practitioner
RN267513
MA
Other
Enumeration date
04/09/2009
Last updated
11/04/2020
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