Individual
JANICE M MCDONOUGH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN CS
Contact information
Practice address
77 MASS AVE, MEDICAL E23-395, CAMBRIDGE, MA 02139-4301
(617) 253-0556
Mailing address
PO BOX 425789, MEDICAL E23-395, CAMBRIDGE, MA 02142-0015
(617) 253-0556
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
98294
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP1372
BLUE CROSS
MA
Enumeration date
02/06/2006
Last updated
07/08/2007
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