Doctor Name: | LYNNE J DOHERTY |
NPI Number: | 1649561630 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | RN196639 |
Business Practice Address: | 24 Common St Suite # 3 Wrentham, MA - 020931399 |
Business Phone Number: | 5083841821 |
Business Fax Number: | |
Mailing Address: | 20 Lyndon Rd, WRENTHAM |
State: | MA |
Postal Code: | 020931155 |
Phone Number: | 5083840505 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2011 |
NPI Last Update Date: | 04/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN196639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |