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Individual

MISHA BORIS YAKOVLEFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
REGISTERED NURSE

Contact information

Practice address
28 ELM ST, CHARLESTOWN, NH 03603-5006
(603) 826-3704
Mailing address
28 ELM ST, CHARLESTOWN, NH 03603-5006
(603) 826-3704

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
064902-21
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
064902-21
REGISTERED NURSE
NH
Enumeration date
06/26/2013
Last updated
06/26/2013
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