Individual
MRS. JESSICA DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-2642
(617) 636-4599
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-2642
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2261788
MA
Other
Enumeration date
07/29/2019
Last updated
10/13/2020
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