Healthcare Provider Details

I. General information

NPI: 1346982758
Provider Name (Legal Business Name): DEBORAH MARGARET ENWRIGHT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 04/07/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67R MOUNT WASHINGTON ST APT 3
LOWELL MA
01854
US

IV. Provider business mailing address

67R MOUNT WASHINGTON ST APT 3
LOWELL MA
01854
US

V. Phone/Fax

Practice location:
  • Phone: 978-972-0692
  • Fax:
Mailing address:
  • Phone: 978-972-0692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number186560
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: