Individual
LISA HEBENSTREIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, RN, ATC
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114
(617) 724-3874
(617) 643-4085
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-3874
(617) 643-4085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2363308
MA
2255A2300X
Athletic Trainer
3104
MA
363L00000X
Nurse Practitioner
Primary
RN2363308
MA
363LF0000X
Family Nurse Practitioner
RN2363308
MA
Other
Enumeration date
07/16/2022
Last updated
07/15/2025
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