Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 142219 | MA |
N | 363LA2100X | Nurse Practitioner - Acute Care | 142219 | MA |
NPI | 1033383757 |
---|---|
Provider Name | Mrs. Jeanne Marie Corrao |
First Address | Boston, MA 02241-5348 |
Second Address | Worcester, MA 01655-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 06/12/2010 |