Healthcare Provider Details

I. General information

NPI: 1073264560
Provider Name (Legal Business Name): TAMARA ANN CHASE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MALL RD
BURLINGTON MA
01805-0002
US

IV. Provider business mailing address

41 MALL RD
BURLINGTON MA
01805-0002
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8000
  • Fax:
Mailing address:
  • Phone: 781-744-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number156113
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: