Healthcare Provider Details

I. General information

NPI: 1386567832
Provider Name (Legal Business Name): REBECCA KEMIGISHA LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DARLENE DR
FITCHBURG MA
01420-4804
US

IV. Provider business mailing address

34 DARLENE DR
FITCHBURG MA
01420-4804
US

V. Phone/Fax

Practice location:
  • Phone: 339-970-4850
  • Fax:
Mailing address:
  • Phone: 339-970-4850
  • Fax: 339-970-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLN102559
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: