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General NPI Number Information
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NPI Number | 1336597251
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Entity Type | Individual
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Provider Name | AMELIA LEUTZ R.N., F.N.P.-B.C.
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Gender | Female
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Dates
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Enumeration Date | 06/01/2016
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Last Update Date | 06/01/2016
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Provider Practice Location Address
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Address Line | 77 MASSACHUSETTS AVE BUILDING E23
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City | CAMBRIDGE
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State | MA
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Zip | 02139-4301
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Country | US
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Telephone | 617-253-0566
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CARLETON ST BUILDING E23
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City | CAMBRIDGE
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State | MA
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Zip | 02142-1323
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Country | US
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Telephone | 617-253-0566
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2272328
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License Number State | MA
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