Individual
JILL A FIELEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
173 MOUNT AUBURN ST, WATERTOWN, MA 02472-4005
(617) 903-5900
(618) 618-6028
Mailing address
3 FAIR OAKS AVE, NEWTON, MA 02460-1216
(857) 205-0441
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
228571NP
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN0287
MEDICARE ID
—
Enumeration date
11/08/2006
Last updated
01/23/2019
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