Healthcare Provider Details

I. General information

NPI: 1730155888
Provider Name (Legal Business Name): LYNNE W FAUST APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WARREN ST LOWELL COMMUNITY HEALTH CENTER
LOWELL MA
01854
US

IV. Provider business mailing address

585 MERRIMACK ST LOWELL COMMUNITY HEALTH CENTER
LOWELL MA
01854
US

V. Phone/Fax

Practice location:
  • Phone: 978-446-0236
  • Fax: 978-446-0248
Mailing address:
  • Phone: 978-446-0236
  • Fax: 978-446-0248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number141978
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: