Healthcare Provider Details

I. General information

NPI: 1134920259
Provider Name (Legal Business Name): LENN DARLA JEAN GILLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WELLESLEY ST
WESTON MA
02493-1572
US

IV. Provider business mailing address

55 COLUMBIA PARK
HAVERHILL MA
01830-3303
US

V. Phone/Fax

Practice location:
  • Phone: 781-768-7000
  • Fax:
Mailing address:
  • Phone: 978-641-0946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN2360021
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: