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Individual

SHELLY ANN ELA PUCKERIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-5155
(978) 937-8177
Mailing address
22 OLD CANAL DR, LOWELL, MA 01851-2730
(978) 452-5155
(978) 937-8177

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN98185
MA

Other

Enumeration date
08/27/2021
Last updated
08/27/2021
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