Healthcare Provider Details

I. General information

NPI: 1700127263
Provider Name (Legal Business Name): EMILY ANN DOUCETTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ANN DUPONT NP

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 WASHINGTON ST
GLOUCESTER MA
01930
US

IV. Provider business mailing address

27 CONGRESS ST STE 513
SALEM MA
01970-5523
US

V. Phone/Fax

Practice location:
  • Phone: 978-282-8899
  • Fax: 978-282-5599
Mailing address:
  • Phone: 978-744-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN271263
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: