Healthcare Provider Details

I. General information

NPI: 1790767994
Provider Name (Legal Business Name): LORETTA GIVENS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARKWAY
HAVERHILL MA
01830-6278
US

IV. Provider business mailing address

1 PARKWAY
HAVERHILL MA
01830-6278
US

V. Phone/Fax

Practice location:
  • Phone: 978-521-3200
  • Fax: 978-313-8558
Mailing address:
  • Phone: 978-521-3200
  • Fax: 978-313-8558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number262615
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code364SP0813X
TaxonomyGeropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN161301
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: