Individual
JENNIE LAREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(508) 864-3793
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(508) 864-3793
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2266891
MA
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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