Healthcare Provider Details

I. General information

NPI: 1154560993
Provider Name (Legal Business Name): BARBARA ANN WUERTHNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST YAWKEY 9-E
BOSTON MA
02114-2621
US

IV. Provider business mailing address

14 ROBERTSON RD
FRAMINGHAM MA
01702-5940
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-4800
  • Fax:
Mailing address:
  • Phone: 617-519-0973
  • Fax: 617-724-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number158038
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: