Individual
MS. AVRIL JOAN JACKSON-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
140 WOOD RD, SUITE 104, BRAINTREE, MA 02184-2508
(781) 884-1539
(800) 708-0401
Mailing address
140 WOOD RD, SUITE 104, BRAINTREE, MA 02184-2508
(781) 884-1539
(800) 708-0401
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
184437
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0706876
—
MA
Enumeration date
07/10/2006
Last updated
04/13/2017
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