Individual
MARY ELLEN OBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
55 FRUIT ST, COX 662, BOSTON, MA 02114-2621
(617) 643-0172
Mailing address
55 FRUIT ST, COX 662, BOSTON, MA 02114-2621
(617) 643-0172
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
217554
MA
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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