Individual
EMMA KAVANAUGH BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
45 DIMOCK ST, ROXBURY, MA 02119-1208
(617) 442-8800
(617) 541-8334
Mailing address
301 NORTH ST APT 1, BOSTON, MA 02113-2141
(973) 255-7790
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN2361944
MA
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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