Healthcare Provider Details

I. General information

NPI: 1649198870
Provider Name (Legal Business Name): LAUREN FITZGERALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 GREAT REPUBLIC AVE
WEYMOUTH MA
02190-2845
US

IV. Provider business mailing address

88 GREAT REPUBLIC AVE
WEYMOUTH MA
02190-2845
US

V. Phone/Fax

Practice location:
  • Phone: 339-499-1534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN2260160
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN2260160
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: