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General NPI Number Information
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NPI Number | 1184972507
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Entity Type | Individual
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Provider Name | KERRY WATROBA FNP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 174 LITTLETON RD MINUTECLINIC
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City | WESTFORD
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State | MA
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Zip | 01886-3191
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Country | US
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Telephone | 978-692-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 4 LOISELLE LN
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City | NORTH CHELMSFORD
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State | MA
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Zip | 01863-1816
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Country | US
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Telephone | 988-886-2438
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2263956
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License Number State | MA
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