Provider Demographics
NPI:1538215389
Name:JEANNE WATSON DRISCOLL, MS,RN,CS,PC
Entity type:Organization
Organization Name:JEANNE WATSON DRISCOLL, MS,RN,CS,PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN, BC
Authorized Official - Phone:617-325-8940
Mailing Address - Street 1:5 SCHIRMER RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1112
Mailing Address - Country:US
Mailing Address - Phone:617-325-8940
Mailing Address - Fax:617-327-8570
Practice Address - Street 1:27 MICA LN
Practice Address - Street 2:SUITE 205
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-1724
Practice Address - Country:US
Practice Address - Phone:781-431-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111854163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty