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General NPI Number Information
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NPI Number | 1942714043
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Entity Type | Individual
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Provider Name | GINA MARIE LORD NP-C
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Gender | Female
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 38 MULBERRY ST
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City | LEEDS
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State | MA
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Zip | 01053-5338
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Country | US
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Telephone | 413-727-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 9 BERWYN STREET EXT
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City | SOUTH HADLEY
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State | MA
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Zip | 01075-1803
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Country | US
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Telephone | 413-221-4061
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN2273496
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License Number State | MA
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