Provider Demographics
NPI:1841372745
Name:ALBERT, S JANE (FNP)
Entity type:Individual
Prefix:
First Name:S
Middle Name:JANE
Last Name:ALBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 WACHUSETT ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4233
Mailing Address - Country:US
Mailing Address - Phone:617-435-0778
Mailing Address - Fax:617-522-9941
Practice Address - Street 1:197 WACHUSETT ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4233
Practice Address - Country:US
Practice Address - Phone:617-435-0778
Practice Address - Fax:617-522-9941
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166285363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily