Healthcare Provider Details

I. General information

NPI: 1558986281
Provider Name (Legal Business Name): COURTNEY LAPERRIERE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 MAIN ST
NORTHBOROUGH MA
01532-1930
US

IV. Provider business mailing address

162 MAIN ST
NORTHBOROUGH MA
01532-1930
US

V. Phone/Fax

Practice location:
  • Phone: 508-770-6701
  • Fax:
Mailing address:
  • Phone: 508-770-6701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: