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General NPI Number Information
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NPI Number | 1639685589
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Entity Type | Individual
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Provider Name | LISA CLEMENTE MSN, AGPCNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 54 HOPEDALE ST STE 9
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City | HOPEDALE
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State | MA
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Zip | 01747-1732
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Country | US
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Telephone | 508-473-8373
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Fax | 508-634-8744
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Provider Business Mailing Address
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Address Line | 114 WATER ST STE 4
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City | MILFORD
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State | MA
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Zip | 01757-3007
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Country | US
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Telephone | 508-473-8373
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Fax | 508-634-8444
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN201245
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 12170041
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License Number State | MA
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