Individual
MRS. HEATHER M TAVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(617) 323-7700
Mailing address
PO BOX 1874, MATTAPOISETT, MA 02739-0448
(508) 789-4521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
198650
MA
363LA2100X
Acute Care Nurse Practitioner
198650
MA
Other
Enumeration date
09/13/2006
Last updated
08/03/2012
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