Individual
JANE MACHARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN281850
MA
363L00000X
Nurse Practitioner
Primary
RN281850
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110128186A
—
MA
Enumeration date
08/24/2017
Last updated
11/24/2020
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