Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN2274291 | MA |
NPI | 1013478981 |
---|---|
Provider Name | Rose Mushi |
First Address | Everett, MA 02149-4642 |
Second Address | Woburn, MA 01801-6554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 11/06/2019 |