Individual
JACQUELYN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C,
Contact information
Practice address
11 SALEM ST STE 15, MEDFORD, MA 02155-3262
(617) 299-0440
Mailing address
39 MITCHELL AVE, MEDFORD, MA 02155-1736
(978) 808-4757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2310867
MA
Other
Enumeration date
02/27/2021
Last updated
02/27/2021
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