Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN2289267 | MA |
NPI | 1043694862 |
---|---|
Provider Name | Elizabeth Tomkinson |
First Address | Worcester, MA 01610-2473 |
Second Address | Worcester, MA 01610-2473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2015 |
Last Update Date | 22/09/2015 |