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Individual

JOHANNA T MCDERMOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
4 BROTHERTON WAY, AUBURN, MA 01501-2684
(508) 832-5917
(508) 832-5751
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN254292
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
254292
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN254292
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
254292
RN LICENSE NUMBER
MA
Enumeration date
09/17/2013
Last updated
02/25/2026
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