MEDICARE: ELIZABETH LABELLA

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
1	163W00000X	Registered Nurse	RN2328675	MA
2	363LF0000X	Family Nurse Practitioner	F06200278	MA

General Provider Information

NPI Number	:	1932724440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LABELLA

Provider Business Mailing Address
First Line	:	270 GROVE ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-7209
Country	:	US
Telephone Number	:	781-356-0714
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 GROVE ST
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-7209
Country	:	US
Telephone Number	:	781-356-0714
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	05/03/2022

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Directions to “ ELIZABETH LABELLA ” Practice Location

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