MEDICARE: MRS. JESSICA IOVANNA FNP-BC

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	363LF0000X	Family Nurse Practitioner	RN2280990	MA

General Provider Information

NPI Number	:	1851112742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA IOVANNA FNP-BC

Provider Business Mailing Address
First Line	:	16 3RD ST
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-2620
Country	:	US
Telephone Number	:	203-464-1285
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 W CENTRAL ST
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-4381
Country	:	US
Telephone Number	:	508-318-6914
Fax Number	:

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

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	10/23/2024

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