MEDICARE: LISA SHRESTHA NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN2335736	MA
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2335736	MA

General Provider Information

NPI Number	:	1023854213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA SHRESTHA NP

Provider Business Mailing Address
First Line	:	33 AVONDALE AVE
Second Line	:
City	:	BILLERICA
State	:	MA
Zip	:	01821-2448
Country	:	US
Telephone Number	:	781-354-8159
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 BEAR HILL RD STE 104
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-1026
Country	:	US
Telephone Number	:	781-775-9111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	01/06/2026

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Directions to “ LISA SHRESTHA NP” Practice Location

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