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NPI Code Detail

MEDICARE: LYNETTE MATTHEWS NP

MEDICARE: LYNETTE MATTHEWS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner229822MA

General Provider Information

NPI Number : 1699969824
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNETTE MATTHEWS NP
Provider Business Mailing Address
First Line : 1200 CENTRE ST
Second Line :
City : ROSLINDALE
State : MA
Zip : 02131-1000
Country : US
Telephone Number : 617-363-8614
Fax Number : 617-363-8929
Provider Business Practice Location Address
First Line : 1200 CENTRE ST
Second Line :
City : ROSLINDALE
State : MA
Zip : 02131-1000
Country : US
Telephone Number : 617-363-8000
Fax Number : 617-363-8929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2007
Last Update Date : 05/18/2021

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