Individual
SARA MANNIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
(617) 972-5100
Mailing address
147 MILK ST, BOSTON, MA 02109-4806
(617) 421-2508
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
119157
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0373991
—
MA
01
—
N348
HPHC
MA
01
—
NP1809
BCBS
MA
Enumeration date
01/19/2007
Last updated
07/08/2007
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