Individual provider · Type 1 NPI
Iris Vicencio-Rasku, NP
Adult Health Nurse Practitioner · Jamaica Plain, MA
NPI number
1972044980
Active
Practice location
150 S Huntington Ave Bldg 9
Jamaica Plain, MA 02130-4817
Fax (857) 364-6003
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | RN276885 (MA) |
| Nurse Practitioner | 363L00000X | RN276885 (MA) |
| Family Nurse Practitioner | 363LF0000X | RN276885 (MA) |
Adult Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1972044980
Iris Vicencio-Rasku, NP's National Provider Identifier is 1972044980, issued on Mar 10, 2017. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Jamaica Plain, MA. The record was last updated on Jul 30, 2026.