Individual
MRS. MARTHA REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, WHNP-BC
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2316889
MA
363LW0102X
Women's Health Nurse Practitioner
Primary
RN2316889
MA
Other
Enumeration date
05/31/2019
Last updated
12/01/2021
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