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General NPI Number Information
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NPI Number | 1558117507
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH BOARDMAN APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 04/29/2024
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-724-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 STONE PL UNIT 201
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City | MELROSE
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State | MA
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Zip | 02176-6032
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Country | US
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Telephone | 603-315-6245
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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 | CNP241163
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2373698
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License Number State | MA
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