Individual
MRS. JESSICA M MATTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
550 1ST AVENUE, 15 EAST SICU, NEW YORK, NY 10016
(508) 404-6518
Mailing address
MGH DEPT OF ANESTHESIA, CRIT CARE AND PAIN, 55 FRUIT STREET, GRB 444, BOSTON, MA 02144-2696
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN276482
MA
363LA2100X
Acute Care Nurse Practitioner
F430649-1
NY
363LA2100X
Acute Care Nurse Practitioner
RN276482
MA
Other
Enumeration date
09/08/2011
Last updated
12/11/2018
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