Individual
MS. THATIANA JEUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
Mailing address
36 BIRD ST, STOUGHTON, MA 02072-3102
(857) 719-3208
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2319961
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2319961
MA
363LP2300X
Primary Care Nurse Practitioner
RN2319961
MA
Other
Enumeration date
07/24/2021
Last updated
07/19/2023
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