Individual
JACQUELYN RAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
700 CROWN COLONY DR, QUINCY, MA 02169-0924
(617) 472-3400
Mailing address
59 KINNICUTT RD, WORCESTER, MA 01602-1548
(508) 439-9575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7210338
MA
363LF0000X
Family Nurse Practitioner
Primary
7210338
MA
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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