Individual
MISS MARAVANNA CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2295788
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN2295788
MA
Other
Enumeration date
11/16/2015
Last updated
06/28/2019
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