Basic Information
Provider Information
NPI: 1164875639
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBRINCK
FirstName: JESSICA
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential: BSN, MPH, FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 SALEM ST
Address2:  
City: WILMINGTON
State: MA
PostalCode: 018871200
CountryCode: US
TelephoneNumber: 9789886000
FaxNumber:  
Practice Location
Address1: 41 HIGHLAND AVE
Address2:  
City: WINCHESTER
State: MA
PostalCode: 018901446
CountryCode: US
TelephoneNumber: 9789886000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2016
LastUpdateDate: 01/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN2300100MAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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