Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN2269726 | MA |
NPI | 1003164773 |
---|---|
Provider Name | Brittany Zolotas |
First Address | Middleton, MA 01949-2446 |
Second Address | Middleton, MA 01949-2446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2012 |
Last Update Date | 28/08/2012 |