Individual
ROSE M FAYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
1400 VFW PKWY, WEST ROXBURY, MA 02132-4927
(857) 203-6140
Mailing address
123 SCHOOL ST, AVON, MA 02322-1869
(617) 763-8526
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
230374
MA
363LA2200X
Adult Health Nurse Practitioner
RN230374
MA
Other
Enumeration date
05/06/2009
Last updated
05/08/2009
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