Individual
CARMELLE M JACQUES II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30 SUMMER ST, HOLBROOK, MA 02343-1050
(781) 767-2773
Mailing address
21 AMANDA ST, MIDDLEBORO, MA 02346-2654
(617) 838-6605
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60085
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324388
—
MA
Enumeration date
04/17/2007
Last updated
07/09/2007
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