Healthcare Provider Details

I. General information

NPI: 1689028102
Provider Name (Legal Business Name): VINI ANAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2016
Last Update Date: 04/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 UNION ST LYNN COMMUNITY HEALTH CENTER
LYNN MA
01901-1314
US

IV. Provider business mailing address

26 DUNCAN DRIVE
BILLERICA MA
01821
US

V. Phone/Fax

Practice location:
  • Phone: 781-596-2502
  • Fax:
Mailing address:
  • Phone: 617-281-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN263404
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: