Individual
MS. PATRICE JACKSON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, ANP-BC, CNP
Contact information
Practice address
83 HOSPITAL RD, BALDWINVILLE, MA 01436-1215
(178) 168-2586
(617) 544-0267
Mailing address
83 HOSPITAL RD, BALDWINVILLE, MA 01436-1215
(178) 168-2586
(617) 544-0267
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2271823
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110095829A
—
MA
Enumeration date
03/03/2013
Last updated
02/17/2023
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