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Individual

ENISE N JEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
676 HYDE PARK AVE, ROSLINDALE, MA 02131-4724
(617) 323-2468
Mailing address
676 HYDE PARK AVE, ROSLINDALE, MA 02131-4724

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
62441
MA

Other

Enumeration date
09/29/2008
Last updated
09/29/2008
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