Healthcare Provider Details

I. General information

NPI: 1962961011
Provider Name (Legal Business Name): HANNAH JOSEPHSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 GRANITE ST STE 2
BRAINTREE MA
02184-5482
US

IV. Provider business mailing address

759 GRANITE ST STE 2
BRAINTREE MA
02184-5482
US

V. Phone/Fax

Practice location:
  • Phone: 781-848-1950
  • Fax: 781-356-4887
Mailing address:
  • Phone: 781-848-1950
  • Fax: 781-356-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN2292221
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2292221
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: