Individual
MS. LISA DONOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-8071
Mailing address
302 CENTRE LN, WALPOLE, MA 02081-3427
(508) 641-2684
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2258902
MA
363LA2100X
Acute Care Nurse Practitioner
RN2258902
MA
Other
Enumeration date
01/30/2016
Last updated
12/12/2022
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