Provider Demographics
NPI:1043397813
Name:WEINTRAUB, JOANNE RUEL
Entity type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:RUEL
Last Name:WEINTRAUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SHERBORN
Mailing Address - State:MA
Mailing Address - Zip Code:01770-1040
Mailing Address - Country:US
Mailing Address - Phone:508-655-7054
Mailing Address - Fax:
Practice Address - Street 1:BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - Street 2:75 FRANCIS STREET ADM A BUILDING, 3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-7129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156949MA363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner