Individual
HASENA OMANOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 875-7651
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 875-7651
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2271503
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110077848
—
MA
Enumeration date
03/31/2014
Last updated
02/17/2016
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