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Individual

JENNIFER A STATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
94 PILGRIM RD, BOSTON, MA 02215-4127
(617) 521-1020
Mailing address
94 PILGRIM RD FL 9, BOSTON, MA 02215-4127
(617) 521-1020
(617) 421-3487

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
217755
MA
363LA2200X
Adult Health Nurse Practitioner
217755
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0382680
MA
01
C198
HARVARD PILGRIM
MA
01
NP3042
BLUE CROSS
MA
Enumeration date
04/03/2006
Last updated
09/25/2024
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