Healthcare Provider Details

I. General information

NPI: 1518512250
Provider Name (Legal Business Name): LOUISA E CODIER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MONTVALE AVE STE 3000
STONEHAM MA
02180-3658
US

IV. Provider business mailing address

526 MAIN ST STE 302
ACTON MA
01720-3301
US

V. Phone/Fax

Practice location:
  • Phone: 781-438-6350
  • Fax: 781-279-0430
Mailing address:
  • Phone: 978-371-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2332036
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: