Individual
PROSSY NANTAMBISTMARIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
879 LEXINGTON STREET, 14B, WALTHAM, MA 02452
(857) 417-7029
(857) 417-7029
Mailing address
879 LEXINGTON STREET, 14B, WALTHAM, MA 02452
(857) 417-7029
(857) 417-7029
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LNNE1004443
MA
Other
Enumeration date
07/30/2026
Last updated
07/30/2026
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