Individual
WENDY J COUTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 632-3420
Mailing address
242 GREEN ST, GARDNER, MA 01440-1336
(978) 632-3420
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
218088
MA
363LA2200X
Adult Health Nurse Practitioner
218088
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0704041
—
MA
01
—
AA43377
HARVARD PILGRIM
MA
01
—
NP5127
BLUE CROSS
MA
Enumeration date
03/17/2006
Last updated
01/21/2010
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