Individual
VADRA WARD TABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Mailing address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
237178
MA
163WC1500X
Community Health Registered Nurse
237178
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN237178
MA
Other
Enumeration date
11/10/2006
Last updated
10/22/2015
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