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General NPI Number Information
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NPI Number | 1700398112
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH MALDONADO CNP
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Gender | Female
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 340 THOMPSON HILL RD
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City | THOMPSON
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State | CT
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Zip | 06277-2223
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Country | US
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Telephone | 774-230-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 55 GREEN ST UNIT D104
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City | CLINTON
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State | MA
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Zip | 01510-3027
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Country | US
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Telephone | 774-230-4100
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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 | RN2270339
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License Number State | MA
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