Individual
LISA DOHERTY WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
55 FRUIT ST, DACC CLINICS 313 MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA 02114-2621
(617) 643-1097
Mailing address
27 WOODMAN ST, #2, JAMAICA PLAIN, MA 02130-3801
(617) 983-0270
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
231486
MA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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