Healthcare Provider Details

I. General information

NPI: 1356041404
Provider Name (Legal Business Name): HANNAH LEMIEUX FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 MAPLE ST STE 204
DANVERS MA
01923-4065
US

IV. Provider business mailing address

480 MAPLE ST STE 204
DANVERS MA
01923-4065
US

V. Phone/Fax

Practice location:
  • Phone: 978-774-0989
  • Fax:
Mailing address:
  • Phone: 978-774-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2317438
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2317438
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: