Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN2293636 | MA |
NPI | 1063986024 |
---|---|
Provider Name | Rosalinda Barrientos |
First Address | Watertown, MA 02472-3087 |
Second Address | Newton, MA 02459-3210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2019 |
Last Update Date | 13/01/2019 |