Individual
MRS. MICQUE ELLYN MORTELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
161 JACKSON ST, LOWELL, MA 01852-2103
(978) 937-9700
(978) 221-6728
Mailing address
12 GAIL RD, MERRIMACK, NH 03054-4556
(978) 995-5705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2291047
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2291047
MA
Other
Enumeration date
06/29/2022
Last updated
04/28/2025
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