Individual
MS. HANATI TARWRISA LUBEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 INGALLS CT, METHUEN, MA 01844-3712
(978) 996-9698
Mailing address
12 INGALLS CT, METHUEN, MA 01844-3712
(978) 996-9698
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN265499
MA
Other
Enumeration date
02/24/2011
Last updated
07/07/2015
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