Basic Information
| Provider Information | |||||||||
| NPI: | 1245306448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMIESON | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 RESEARCH PL STE 310 | ||||||||
| Address2: | |||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784592152 | ||||||||
| FaxNumber: | 9784527285 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 RESEARCH PL STE 310 | ||||||||
| Address2: | |||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6177827788 | ||||||||
| FaxNumber: | 6177835657 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 182212 | MA | N | Nursing Service Providers | Registered Nurse | 363L00000X | RN182212 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.