Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN274075 | MA |
N | 363LP2300X | Nurse Practitioner - Primary Care | RN274075 | MA |
NPI | 1003353012 |
---|---|
Provider Name | Marcelle Fallica Saurman |
First Address | Winchester, MA 01890-1773 |
Second Address | Chelmsford, MA 01824-2712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2017 |
Last Update Date | 17/03/2018 |