Healthcare Provider Details

I. General information

NPI: 1619188265
Provider Name (Legal Business Name): ANNE ELIZABETH LOMBARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 GOVERNORS AVE
MEDFORD MA
02155-1643
US

IV. Provider business mailing address

18 LILAC LN
SANDOWN NH
03873-2067
US

V. Phone/Fax

Practice location:
  • Phone: 781-306-6592
  • Fax:
Mailing address:
  • Phone: 603-887-1715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number198559
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: