Individual
ALEXI LYNN PROVENCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9 VILLAGE INN RD, WESTMINSTER, MA 01473-1643
(978) 571-6050
Mailing address
49 ANZIO RD, ATHOL, MA 01331-1201
(774) 381-2550
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN95191
MA
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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