Healthcare Provider Details

I. General information

NPI: 1770428682
Provider Name (Legal Business Name): MEGHAN LYNN GUIDOBONI BSN, RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 SECOND AVE STE 400
WALTHAM MA
02451-1137
US

IV. Provider business mailing address

3 MONMOUTH ST APT 1
BOSTON MA
02128-1381
US

V. Phone/Fax

Practice location:
  • Phone: 781-487-4340
  • Fax: 781-487-4341
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2317004
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: