MEDICARE: JESSICA MARILYNN HERRERA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN2379315	MA

General Provider Information

NPI Number	:	1821950197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MARILYNN HERRERA NP

Provider Business Mailing Address
First Line	:	38 STANLEY ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02125-4239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 COLUMBIA RD
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02121-3409
Country	:	US
Telephone Number	:	617-237-6838
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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