Healthcare Provider Details

I. General information

NPI: 1558772392
Provider Name (Legal Business Name): JENNIFER LOBIK PMHNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 07/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ARCH PL
GREENFIELD MA
01301-2457
US

IV. Provider business mailing address

1 ARCH PL
GREENFIELD MA
01301-2457
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-1000
  • Fax:
Mailing address:
  • Phone: 413-774-1000
  • Fax: 413-774-1776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTAP5579
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number195577
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: