Individual
MERCY N ENEMCHUKWU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
27 FISKE AVE, WALTHAM, MA 02453-7703
(617) 335-0975
(781) 642-5725
Mailing address
27 FISKE AVE, WALTHAM, MA 02453-7703
(617) 335-0975
(781) 642-5725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN204682
MA
363LF0000X
Family Nurse Practitioner
Primary
RN/NP204682
MA
Other
Enumeration date
06/06/2012
Last updated
07/29/2012
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