Healthcare Provider Details

I. General information

NPI: 1225050933
Provider Name (Legal Business Name): LISA MARIE VASILE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 MAIN ST 4 BETTER HEALTH INC
HOPKINTON MA
01748
US

IV. Provider business mailing address

85 MAIN ST 4 BETTER HEALTH, INC
HOPKINTON MA
01748
US

V. Phone/Fax

Practice location:
  • Phone: 508-625-1807
  • Fax: 508-625-1162
Mailing address:
  • Phone: 508-625-1807
  • Fax: 508-625-1162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number195359
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number195359
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: