Healthcare Provider Details

I. General information

NPI: 1730159781
Provider Name (Legal Business Name): LISSA BETH SINGER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 03/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE CHARLTON MEMORIAL HOSP - ED
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

204 BROOK ST
REHOBOTH MA
02769-1736
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-7215
  • Fax: 508-679-7279
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNPP23110
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: