Individual
REA PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 WASHINGTON ST, NORTH EASTON, MA 02356-1012
(617) 230-0265
Mailing address
66 WASHINGTON ST, NORTH EASTON, MA 02356-1012
(617) 230-0265
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN90131
MA
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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