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Individual

MRS. MARTHA P SLATTERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
650 CENTRE ST, SUITE 102W, BROCKTON, MA 02302-3308
(508) 580-8682
(508) 583-2515
Mailing address
650 CENTRE ST, SUITE 102W, BROCKTON, MA 02302-3308
(508) 580-8682
(508) 583-2515

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
103002
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110085882A
MA
Enumeration date
09/23/2008
Last updated
03/28/2018
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