Healthcare Provider Details

I. General information

NPI: 1124227004
Provider Name (Legal Business Name): JESSICA LEE LAPREL RNC NPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LORING DRIVE HEALTH SERVICES UNIT
FRAMINGHAM MA
01701
US

IV. Provider business mailing address

99 LORING DRIVE
FRAMINGHAM MA
01701
US

V. Phone/Fax

Practice location:
  • Phone: 508-532-5100
  • Fax:
Mailing address:
  • Phone: 508-532-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number262074
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number262074
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: