Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2275025 | MA |
NPI | 1023425543 |
---|---|
Provider Name | Ms. Bridget Albert |
First Address | Westford, MA 01886-3198 |
Second Address | Fitchburg, MA 01420-7111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2014 |
Last Update Date | 18/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2275025 | MASSACHUSETTS STATE NURSE PRACTITIONER LICENSE (01) | MA |