Provider Demographics
NPI:1912081415
Name:MAFFIE LEE, JANE L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:L
Last Name:MAFFIE LEE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:110 W SQUANTUM ST
Mailing Address - Street 2:MANET COMMUNITY HEALTH CENTER INC
Mailing Address - City:NO QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2122
Mailing Address - Country:US
Mailing Address - Phone:617-376-3000
Mailing Address - Fax:617-774-1906
Practice Address - Street 1:1193 SEA ST
Practice Address - Street 2:MANET COMMUNITY HEALTH CENTER
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02045-3069
Practice Address - Country:US
Practice Address - Phone:617-471-8683
Practice Address - Fax:617-773-1625
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA118793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P22354Medicare UPIN
NP2998Medicare ID - Type Unspecified