Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN2294060 | MA |
NPI | 1114511748 |
---|---|
Provider Name | Annemarie Kerry |
First Address | Weymouth, MA 02189-2137 |
Second Address | Boston, MA 02115-5724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2021 |
Last Update Date | 24/02/2021 |