Individual
MISS LISA NUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN/PC
Contact information
Practice address
12 ALFRED ST, SUITE 200, WOBURN, MA 01801-1972
(781) 646-0500
(781) 646-7130
Mailing address
36 PHOEBE AVE, LOWELL, MA 01854-2409
(978) 459-8836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
229836
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305638
—
MA
Enumeration date
10/01/2007
Last updated
08/17/2009
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