Individual
DESTINY EVANGELINE FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
451 LOWELL ST, READING, MA 01867-1533
(781) 248-8569
Mailing address
451 LOWELL ST, READING, MA 01867-1533
(781) 248-8569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2295954
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2295954
MA
Other
Enumeration date
08/02/2021
Last updated
02/19/2025
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