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General NPI Number Information
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NPI Number | 1184221921
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Entity Type | Individual
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Provider Name | EDITH ESTRADA JUHLIN APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 05/09/2026
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Provider Practice Location Address
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Address Line | 1192 BLUE HILL AVE
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City | MATTAPAN
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State | MA
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Zip | 02126-1819
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Country | US
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Telephone | 617-201-1002
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Fax | 844-564-1409
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Provider Business Mailing Address
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Address Line | 85 PATTON RD
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City | DEVENS
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State | MA
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Zip | 01434-4401
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Country | US
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Telephone | 978-615-5223
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN05058
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN23334377
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2334377
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License Number State | MA
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