Individual
LISA MASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94 ANTRIM ST, CAMBRIDGE, MA 02139-1102
(603) 674-7974
Mailing address
94 ANTRIM ST, CAMBRIDGE, MA 02139-1102
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
2270007
MA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
2270007
MA
Other
Enumeration date
03/18/2014
Last updated
06/12/2023
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