Individual
MS. CAILIN ELEANOR DURAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1055 COMMONWEALTH AVE, BOSTON, MA 02215-1001
(617) 616-1660
Mailing address
1055 COMMONWEALTH AVE, BOSTON, MA 02215-1001
(617) 616-1660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN279143
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301071
GROUP MEDICAID NUMBER
MA
Enumeration date
09/21/2009
Last updated
01/13/2015
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