Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN2261931 | MA |
N | 363LA2200X | Nurse Practitioner - Adult Health | RN2261931 | MA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN2261931 | MA |
NPI | 1013419217 |
---|---|
Provider Name | Mrs. Julie Frances Vergados Simoneau |
First Address | Lowell, MA 01851-2908 |
Second Address | Lowell, MA 01854-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2018 |
Last Update Date | 02/03/2018 |