Individual
STACEY L JODICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
800 HUNTINGTON AVE FL 3, BOSTON, MA 02115-6303
(617) 525-9548
Mailing address
28 HYCREST RD, CHARLTON, MA 01507-1568
(413) 329-9017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN2294699
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN2294699
MA
Other
Enumeration date
08/12/2019
Last updated
06/30/2025
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