Individual
MISS NICOLE MARIE MENTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
15 GALLANT RD, PEABODY, MA 01960-1876
(978) 767-6466
Mailing address
15 GALLANT RD, PEABODY, MA 01960-1876
(978) 767-6466
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2285358
MA
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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