Individual
MISS MICHELE JACQUELINE BORISUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
300 LONGWOOD AVE, FARLEY 612, BOSTON, MA 02115-5724
(617) 355-3515
Mailing address
300 LONGWOOD AVENUE, FARLEY 612, BOSTON, MA 02115
(617) 355-3515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TP006200D
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2269575
MA
363LP0222X
Critical Care Pediatric Nurse Practitioner
5003911
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1261
—
NC
Enumeration date
10/27/2006
Last updated
07/09/2013
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