Individual
AQID NASIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC, MSN
Contact information
Practice address
295 VARNUM AVE, LOWELL, MA 01854-2193
(978) 937-6000
Mailing address
109 ADAMS AVE, NORTH ANDOVER, MA 01845-4304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2326407
MA
Other
Enumeration date
04/16/2025
Last updated
04/16/2025
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