Healthcare Provider Details

I. General information

NPI: 1801519038
Provider Name (Legal Business Name): WHITNEY BOSTON ULMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 KENDRICK ST
NEEDHAM MA
02494-2760
US

IV. Provider business mailing address

8 YORKTOWN RD
WEST BOYLSTON MA
01583-2017
US

V. Phone/Fax

Practice location:
  • Phone: 781-707-9524
  • Fax:
Mailing address:
  • Phone: 978-333-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2295255
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberRN2295255
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: