Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 106539 | MA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 106539 | MA |
NPI | 1013981141 |
---|---|
Provider Name | Jean D Horst |
First Address | Boston, MA 02109-4806 |
Second Address | Wellesley, MA 02481-5420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0359131 | (05) | MA |
NP9982 | BLUE CROSS (01) | MA |
PN651 | HARVARD PILGRIM (01) | MA |
S88323 | (02) | MA |