Healthcare Provider Details

I. General information

NPI: 1164582201
Provider Name (Legal Business Name): CHERYL LUCCHETTI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CORDAGE PARK CIR SUITE 211
PLYMOUTH MA
02360-7318
US

IV. Provider business mailing address

362 COURT ST
PLYMOUTH MA
02360-4397
US

V. Phone/Fax

Practice location:
  • Phone: 508-747-1443
  • Fax: 508-830-6850
Mailing address:
  • Phone: 508-747-1443
  • Fax: 508-830-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number265199
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: