Healthcare Provider Details

I. General information

NPI: 1861369472
Provider Name (Legal Business Name): NICOLE LONERGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 SOUTHBRIDGE ST
AUBURN MA
01501-2548
US

IV. Provider business mailing address

77 LAKE ST
BELLINGHAM MA
02019-2113
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-7118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2292585
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: