Healthcare Provider Details

I. General information

NPI: 1922548403
Provider Name (Legal Business Name): JONATHAN JEHLE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

330 BROOKLINE AVE YAMINS 203
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 617-667-3364
  • Fax: 617-667-5013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN240039
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: