Healthcare Provider Details

I. General information

NPI: 1346166998
Provider Name (Legal Business Name): JAZMINE LIMA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

55 LOWELL ST # 2
SOMERVILLE MA
02143-2438
US

V. Phone/Fax

Practice location:
  • Phone: 617-834-7549
  • Fax:
Mailing address:
  • Phone: 617-834-7549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06261324
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: