Individual
JENNIFER BACEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1601 WASHINGTON ST, BOSTON, MA 02118-1951
(617) 425-2000
Mailing address
1601 WASHINGTON ST, BOSTON, MA 02118-1951
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2303773
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2303773
RN LICENSE
MA
Enumeration date
07/03/2017
Last updated
07/03/2017
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