Healthcare Provider Details

I. General information

NPI: 1396362596
Provider Name (Legal Business Name): EMILY LAWLOR UNDERWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2020
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 ORNAC STE 830
CONCORD MA
01742-4191
US

IV. Provider business mailing address

131 ORNAC STE 830
CONCORD MA
01742-4191
US

V. Phone/Fax

Practice location:
  • Phone: 978-371-1396
  • Fax: 978-371-8277
Mailing address:
  • Phone: 978-371-1396
  • Fax: 978-371-8277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRN2318219
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: