Healthcare Provider Details

I. General information

NPI: 1396236543
Provider Name (Legal Business Name): NICOLE RINN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 MAIN ST STE 400
S WEYMOUTH MA
02190-1889
US

IV. Provider business mailing address

541 MAIN ST STE 400
S WEYMOUTH MA
02190-1889
US

V. Phone/Fax

Practice location:
  • Phone: 781-952-1240
  • Fax: 781-952-1240
Mailing address:
  • Phone: 781-952-1240
  • Fax: 781-952-1240

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: