Michele Jacqueline Borisuk, RN, CPNP
Nurse Practitioner, Pediatrics in Boston, MA. Individual provider (NPI-1).
NPI number1386720175
StatusActive
Last updated in NPPESJul 9, 2013
Details
- NPI
- 1386720175
- Entity type
- Individual (NPI-1)
- Name
- Miss Michele Jacqueline Borisuk
- Credential
- RN, CPNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 27, 2006
- Last updated
- Jul 9, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | RN2269575 | MA | Yes |
| 363LP0222X | Nurse Practitioner, Pediatrics, Critical Care | 5003911 | NC | |
| 363L00000X | Nurse Practitioner | TP006200D | PA |
Practice location
300 Longwood AveFarley 612
Boston, MA 02115-5724
Phone 617-355-3515
Mailing address
300 Longwood AvenueFarley 612
Boston, MA 02115
Phone 617-355-3515
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