Individual
MRS. LISA MOORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
140 WORCESTER ST, WEST BOYLSTON, MA 01583-1765
(508) 835-6666
Mailing address
11 BERRY LN, ACTON, MA 01720-5503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
254843
MA
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
10947611
MA
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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