Provider Demographics
NPI:1891045738
Name:BARTEL, JEANNE M (ANP)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:M
Last Name:BARTEL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:M
Other - Last Name:IWATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:62 WHITTEMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1623
Mailing Address - Country:US
Mailing Address - Phone:617-498-4963
Mailing Address - Fax:
Practice Address - Street 1:62 WHITTEMORE AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1623
Practice Address - Country:US
Practice Address - Phone:617-498-4963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152527363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health