Individual
JESSICA A. MAITLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
88 WASHINGTON ST, TAUNTON, MA 02780-2499
(508) 828-7100
Mailing address
423 FORTRESS BLVD, MORGANTOWN, WV 26508-1351
(844) 852-9510
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
S71701618
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110105527A
—
MA
Enumeration date
08/05/2014
Last updated
01/08/2024
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