Individual
JOHN L BOISSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
190 LENOX ST, NORWOOD, MA 02062-3416
(781) 769-8670
Mailing address
295 BLACKSTONE ST, BLACKSTONE, MA 01504-1312
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
225680
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JB62852
—
RI
Enumeration date
12/19/2006
Last updated
09/04/2007
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