Individual
MS. JACQUELINE AIMEE DALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-2000
Mailing address
855 CENTRAL AVE, ALBANY, NY 12206-1513
(518) 434-5678
(518) 434-0732
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN2292036
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
307572
NY
363LW0102X
Women's Health Nurse Practitioner
421273
NY
Other
Enumeration date
02/02/2016
Last updated
04/29/2026
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