Individual
JILLIAN LUCEY KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4 CENTENNIAL DR STE 204, PEABODY, MA 01960-7930
(978) 977-0351
Mailing address
321 ESSEX AVE, GLOUCESTER, MA 01930-2301
(978) 808-5476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2264536
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2264536
MA
Other
Enumeration date
12/09/2018
Last updated
12/09/2018
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