Individual
POLIANA LARISSA LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 HOSPITAL RD, LEOMINSTER, MA 01453-2253
(978) 466-4212
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2266782
MA
363LA2100X
Acute Care Nurse Practitioner
RN2266782
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110103877A
—
MA
Enumeration date
11/07/2014
Last updated
11/04/2020
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