Individual
JESSICA JEANNE SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8000
Mailing address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2306549
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN2306549
MA
Other
Enumeration date
02/02/2017
Last updated
06/10/2021
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