Individual
MS. JAMIE C. MORTELLITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-1949
(617) 667-9922
Mailing address
46 LOWELL RD, NORTH READING, MA 01864-1632
(781) 910-0322
(617) 667-9922
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
254663
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0703095
—
MA
01
—
21258700817
BEECH STREET
MA
01
—
94036
FALLON
MA
01
—
NP4995
BLUE CARE 65
MA
Enumeration date
03/30/2007
Last updated
07/08/2007
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