Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Mary Lane Jackmin, PA-C

Individual provider Physician Assistant · NPI 1427225929

Mrs. Mary Lane Jackmin, PA-C is a Physician Assistant in Boston, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2008.

Licensed in
MA
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

333 Longwood Ave 3rd Fl
Boston, MA 02115-5711
Phone: (617) 355-0648
Fax: (617) 730-0337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 2416 (MA)
Physician Assistant Taxonomy 363A00000X · Licence 2416 (MA)

Record details

NPI number1427225929
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 14, 2008
Last updated in NPPESMay 14, 2008

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