Healthcare Provider Details

I. General information

NPI: 1457262693
Provider Name (Legal Business Name): IVETTE ACOSTA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WOODLAND N
LYNN MA
01904-1414
US

IV. Provider business mailing address

24 ROCKINGHAM ST APT 1
LYNN MA
01902-2736
US

V. Phone/Fax

Practice location:
  • Phone: 781-715-6692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2370213
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: