Individual
BLONDEL JARVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 SCALLY CIR, RANDOLPH, MA 02368-2443
(339) 837-1449
(339) 837-1076
Mailing address
75 N MAIN ST # 578, RANDOLPH, MA 02368-4605
(339) 837-1449
(339) 837-1076
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN241852
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN241852
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225317670
—
MA
Enumeration date
08/16/2011
Last updated
02/24/2023
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