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General NPI Number Information
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NPI Number | 1467555607
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Entity Type | Individual
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Provider Name | LORI WILLIAMS APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 486 CHANDLER ST # G209 WORCESTER STATE COLLEGE STUDENT HEALTH SERVICES
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City | WORCESTER
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State | MA
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Zip | 01602-2861
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Country | US
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Telephone | 508-929-8875
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Fax | 508-929-8075
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Provider Business Mailing Address
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Address Line | 25 MEADOW LN
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City | SOUTHBOROUGH
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State | MA
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Zip | 01772-1340
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Country | US
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Telephone |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 190668
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License Number State | MA
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