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Individual

GWENDOLYN ESCOBAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
125 N ELM ST, WESTFIELD, MA 01085-3464
(413) 568-6600
(413) 572-6840
Mailing address
125 N ELM ST, WESTFIELD, MA 01085-3464
(413) 568-6600
(413) 572-6840

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN99235
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S60885968
DRIVER LICENSE
MA
Enumeration date
07/29/2021
Last updated
07/29/2021
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