Healthcare Provider Details

I. General information

NPI: 1700644101
Provider Name (Legal Business Name): LUCILE LEA REZIL NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. LUCILE LEA FRANCOIS

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 BROWNELL ST
ATTLEBORO MA
02703-5036
US

IV. Provider business mailing address

93 BROWNELL ST
ATTLEBORO MA
02703-5036
US

V. Phone/Fax

Practice location:
  • Phone: 857-233-7922
  • Fax:
Mailing address:
  • Phone: 857-233-7922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN2325225
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: