Individual
JOHANNE JEUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
732 HARRISON AVE, FL 2, PRESTON BLDG, BOSTON, MA 02118-2309
(617) 638-7470
(617) 638-7449
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN267732
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110094697A
—
MA
Enumeration date
10/21/2010
Last updated
06/21/2023
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