Healthcare Provider Details

I. General information

NPI: 1306737598
Provider Name (Legal Business Name): EMILY A MAILLET FNP-BC (APRN)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 MALL RD STE 240
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

35 MYSTIC ST APT 2
CHARLESTOWN MA
02129-2073
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-7954
  • Fax: 781-744-5044
Mailing address:
  • Phone: 508-523-9758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2333568
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: