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General NPI Number Information
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NPI Number | 1790591667
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Entity Type | Individual
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Provider Name | JENNIFER SERVANT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 300 BOYLSTON ST
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-1959
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Country | US
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Telephone | 617-485-5660
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Fax |
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Provider Business Mailing Address
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Address Line | 604 GAZEBO CIR
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City | READING
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State | MA
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Zip | 01867-4062
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Country | US
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Telephone | 603-359-2543
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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 | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | RN2342822
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License Number State | MA
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