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Individual

JEAN M DONOHUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
111 GROSSMAN DR, BRAINTREE, MA 02184-4997
(781) 849-1000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95709
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
95709
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0358321
MA
01
N221
HARVARD PILGRIM
MA
01
NP1810
BLUE CROSS
MA
Enumeration date
03/20/2006
Last updated
10/08/2013
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