Healthcare Provider Details

I. General information

NPI: 1891414900
Provider Name (Legal Business Name): ANGELINA CHHIM LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 BURDETTE RD
DRACUT MA
01826-3636
US

IV. Provider business mailing address

34 HAVERHILL ST
LAWRENCE MA
01841-2884
US

V. Phone/Fax

Practice location:
  • Phone: 978-942-9522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLN102216
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: