Basic Information
| Provider Information | |||||||||
| NPI: | 1003353012 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAURMAN | ||||||||
| FirstName: | MARCELLE | ||||||||
| MiddleName: | FALLICA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 60 WICKFORD RD | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018901773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817999436 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31 VILLAGE SQ | ||||||||
| Address2: | |||||||||
| City: | CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018242712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782569507 | ||||||||
| FaxNumber: | 9782441423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | RN274075 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LA2200X | RN274075 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.