Individual
JAMIE RUTH INEGBEDION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
98 BOUNDARY ST, BROCKTON, MA 02302-1111
(508) 404-4493
Mailing address
98 BOUNDARY ST, BROCKTON, MA 02302-1111
(508) 404-4493
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN92069
MA
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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