Individual
JULIE L WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
850 HARRISON AVE, YACC, 3RD FLOOR, BOSTON, MA 02118-4001
(617) 638-6100
(617) 638-6179
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
271026
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110074615A
—
MA
Enumeration date
12/26/2006
Last updated
07/03/2014
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