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General NPI Number Information
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NPI Number | 1104069400
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Entity Type | Individual
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Provider Name | JAIME JEANETTE ECKERT RN, PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-724-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 170 MORTON ST MICHAEL J. GILL MENTAL HEALTH & WELLNESS CLINIC
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3735
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | RN272291
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 272291
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License Number State | MA
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